Fellowship in Primary Spine Care
Courses Certified  By, and In Joint Providership With
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Why Primary Spine Care Is Needed

Back pain is one of the most common—and most misunderstood—health conditions in the world.

Peer-reviewed literature consistently shows that over 30% of the population suffers from back pain at any given time, with a lifetime prevalence ranging from 50% to 80%. Despite this overwhelming burden, the majority of patients enter a healthcare system that lacks sufficient training in spinal biomechanics, functional instability, and non-anatomical spinal pathology.

This gap has real consequences:

  • Delayed or missed diagnoses

  • Overreliance on pharmaceuticals

  • Unnecessary imaging, injections, or surgery

  • Poor long-term outcomes

Recognizing this failure, recent clinical practice guidelines from the American College of Physicians (ACP) clearly recommend non-pharmacologic care as the first-line treatment for spinal pain. The evidence in literture further validates chiropractic as a "superior choice" as the first provider for spine based on outcome studies. 

The critical question becomes:

Who is actually trained to deliver that level of care safely, accurately, and independently?

What Is a Primary Spine Care Provider?

A Primary Spine Care (PSC) Provider is a doctor with advanced, post-graduate training dedicated exclusively to the diagnosis, management, and coordination of care for spinal-related conditions—particularly mechanical and neuro-biomechanical spine pain.

Unlike general primary care, the PSC model is spine-specific, evidence-based, and triage-driven.

A Primary Spine Care Provider Is Trained In:

  • Comprehensive spinal diagnosis and prognosis

  • Advanced interpretation of MRI, CT, and functional imaging

  • Electrodiagnostic testing and neurological correlation

  • Vascular assessment related to stroke risk

  • Central motor and sensory lesion differentiation

  • Identification of red-flag conditions and co-morbidities

  • Independent management of non-anatomical and ligamentous pathology

  • Collaboration and referral to medical and surgical specialists when appropriate

What PSC Providers Do Not Treat:

PSC providers do not typically manage fractures, tumors, or infections—but they are specifically trained to recognize, diagnose, and triage these conditions immediately.

In short, PSC providers serve as the front-line spinal diagnosticians, ensuring patients enter the right pathway of care at the right time.

Who Should Serve as a Primary Spine Care Provider?

Because spinal diagnosis directly affects neurologic function, long-term disability risk, and patient safety, Primary Spine Care is not an entry-level role.

The Primary Spine Care Fellowship was developed to address this public health need by producing doctors with the highest level of spine-specific clinical competence.

Fellowship Overview

  • Two-year post-graduate Fellowship

  • Focused on advanced spinal diagnosis, prognosis, and case management

  • Designed for doctors managing complex spine cases in clinical, forensic, and interdisciplinary settings

Academic & Institutional Credentials

  • Certified by Cleveland University–Kansas City, College of Chiropractic

    • A CCE-accredited doctoral institution

       

  • Courses offered in joint providership Approved through:

    • State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Department of Continuing Medical Education

    • Faculty includes professors from:

      • CCE-accredited chiropractic institutions

      • ACCME-accredited medical academia

Why Only Licensed Doctors Are Eligible

Spinal diagnosis and prognosis carry significant medico-legal and public health implications. Improper assessment can result in:

  • Missed neurologic injury

  • Permanent disability

  • Delayed stroke or vascular events

  • Incorrect impairment ratings

  • Inappropriate surgical referrals

For this reason, only licensed doctors are eligible to serve as Primary Spine Care Providers or to enter the Fellowship program.

Allowing non-doctors to function in this role would constitute a significant public health risk.

The Bottom Line

Primary Spine Care exists because the current system fails spine patients.

PSC providers fill the critical gap between:

  • Primary care medicine

  • Pain management

  • Imaging

  • Surgery

They deliver evidence-based, guideline-aligned, non-pharmacologic spinal care—while ensuring accurate diagnosis, appropriate triage, and interdisciplinary collaboration.

Primary Spine Care is not an alternative to medical specialists
It is a necessary evolution as a first step because of it.

Questions? Dr. Mark Studin : 631.786.4253
Fellowship Coordinator