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Home › Online Course Categories › Case Studies & Clinical Pearls › 211: Lumbar Spine Conditions II
Case Studies & Clinical Pearls 211 — at a Glance
| Course: | Lumbar Spine Conditions II — Sequestration, Modic Changes & Instability · 2 CE hours · $40 |
| Faculty: | Monte Horne, DC · founder of CCEDseminars, 39+ years in practice, expert witness and peer reviewer |
| Format: | On-demand online video with case walk-throughs and assessment · downloadable handouts · instant certificate |
| Pricing: | $20/hr · automatic 10% off at 6–9 hrs, 20% off at 10+ hrs in one order · no promo codes |
| Approval: | PACE Provider #34015544 · co-sponsored by Texas Chiropractic College · acceptance varies by state |
Board-approved · PACE Provider #34015544 · CE Broker auto-reporting for states served · Instant certificate
Case Studies & Clinical Pearls 211 takes the low back into its highest-stakes territory — disc sequestration, Modic changes, and unstable spondylolisthesis. Dr. Monte Horne brings 39 years of clinical experience to the cases where the decision is not only how to treat, but whether to treat, and how to say so clearly to the patient and to the co-managing physician who reads your note next.
For the unstable lumbar patient, shear and protective guarding are what you are actually tracking, so single leg balance and prone instability testing become the Clinical Audit — objective, repeatable proof of improved neuromuscular control and spinal stability after the adjustment. This 2-hour online course works the two cases that decide a low-back care plan: the clinical tipping point that separates a conservatively managed sequestrated disc from one that demands immediate neurosurgical referral, and what Modic Type I versus Type II changes on MRI should do to your adjustive force, your frequency of care, and the expectations you set. Every completion generates an instant certificate for your renewal file.
Choose Your Case Study Path — Three Lanes, One Curriculum
The catalog is organized as a curriculum, not a pile of hours — 23 courses and 42 CE hours covering every region head-to-foot across two series, plus specialist case files. Start in the lane that matches your patient mix; the full catalog lives on the Case Studies & Clinical Pearls category page.
1 · The Regional Series — First Pass (201–206)
A complete head-to-foot tour of case-based diagnosis — the foundation lane.
201: Headache Diagnosis & Clinical Pearls
202: The Cervical Spine
203: Upper Extremities
204: Thorax Conditions & Clinical Pearls
205: Lumbar Spine Diagnosis
206: Lower Extremity Conditions & Clinical Pearls
2 · The Regional Series — Second Pass (207–212)
The same regions revisited with new cases and deeper differentials — the lane that turns pattern recognition into judgment. You are here: Case Studies & Clinical Pearls 211.
207: The Head II
208: The Cervical Spine II
209-A / 209-B: The Upper Extremities II, Parts I & II
210-A / 210-B: The Thorax II, Parts I & II
211: Lumbar Spine Conditions II
212: Lower Extremity Conditions II
3 · Specialist Case Files (213–221)
Board-credentialed faculty open their own files — condition-specific cases from orthopedic, sports, extremity, and nutrition practice.
213: Headache Management & Diagnosis
214: From Anatomy to Diagnoses
215: Case Studies Related to the TMJ
216: Disc Herniation
217: Spondylolisthesis Treatment
218: Carpal Tunnel Syndrome Treatment
219: TMD
220: Soft Tissue Injuries
221: Headache Management & Treatment
New case files are added to these lanes as faculty release them.
What You'll Learn in Case Studies & Clinical Pearls 211
• Work the most complex low-back presentations through real case studies — disc sequestration, Modic changes, and unstable spondylolisthesis — and the reasoning that separates conservative management from referral.
• Use single leg balance and prone instability testing as Clinical Audit measures of shear and protective guarding — demonstrating immediate post-adjustment gains in neuromuscular control and spinal stability.
• Master the sequestration protocol: the neurological indicators that mark the clinical tipping point between conservative care and immediate neurosurgical referral in a sequestrated disc.
• Decode Modic Type I versus Type II changes on MRI and translate them into adjustive force, frequency of care, and patient expectations — then communicate the prognosis in courtroom-defensible form.
Your Case Studies & Clinical Pearls Faculty
Monte Horne, DC — instructor of this course — authors the fourteen-course regional core (201–212), drawing on 39+ years of practice, service as a former Designated Doctor for the Texas Department of Insurance, and ongoing work as an expert witness and peer reviewer. Founder of CCEDseminars and postgraduate faculty for Texas Chiropractic College, Dr. Horne teaches clinical reasoning, orthopedics, documentation, and medicolegal standards; his cases teach decision-making the way case review demands it — reasoning a second reader can follow.
Steven Yeomans, DC, FACO brings orthopedic board credentials to the three highest-stakes structural files — disc herniation, spondylolisthesis, and carpal tunnel syndrome (216–218) — the same conditions at the center of his documentation and personal injury teaching.
Heather Wright, DC, CCEP teaches headache management and diagnosis, the anatomy-to-diagnosis bridge, and TMJ case studies (213–215) with an extremity-certified chiropractor's structural precision.
Howard Benedikt, DC, DCBCN — board-certified in clinical nutrition — works the TMD and headache management files (219, 221) where structure, physiology, and nutrition intersect.
Dennis O'Hara, DC, DACBSP opens the soft tissue injury file (220) with a sports diplomate's tissue-healing timeline.
Full bios and the complete instructor roster: CCEDseminars faculty page.
Where Case Study Hours Count — State Rules Worth Knowing
Case study coursework is clinical subject matter — assessment, diagnosis, and case management — which is exactly what several state boards ask for. In Iowa, these hours serve the 36-hour clinical case-management minimum (this category is case management, by name and by content); in Rhode Island, they address the 50-of-60 clinical requirement; and in Vermont — where practice-building coursework earns nothing — patient-care education like this counts fully under the clinical-focus rule.
Online-format allowances still vary by state — some accept every hour online, others cap distance learning or require in-person blocks. Check your state's guide in the full state directory before building your renewal plan.
Build Your Case Study Block
Most courses in the series run 2 hours at $40 (the four Series II split-courses, 209-A/B and 210-A/B, run 1 hour at $20 each), so the automatic discounts do the bundling for you: 6–9 hours in one order earns 10% off, and 10 or more earns 20% off — the full second-pass series, or all 42 hours at roughly $672 instead of $840, with no promo codes. The natural pairing for this course is the rest of the Second Pass lane: 210-A / 210-B The Thorax II sit directly above it and 212 Lower Extremity Conditions II continues down the chain; 205 Lumbar Spine Diagnosis is the first-pass companion to this course. Browse Case Studies & Clinical Pearls Courses
Case Studies & Clinical Pearls 211 — Frequently Asked Questions
What does Case Studies & Clinical Pearls 211 cover?
Second-pass case studies of the lumbar spine at its most complex: disc sequestration and the clinical tipping point for neurosurgical referral; Modic Type I versus Type II changes on MRI and what they should do to adjustive force, frequency of care, and prognosis; unstable spondylolisthesis; and single leg balance and prone instability testing as Clinical Audit measures of shear, protective guarding, and neuromuscular control. Also known as Modic changes chiropractic CE, sequestered disc management, lumbar instability testing, spondylolisthesis case studies, and low back differential diagnosis for chiropractors.
How many CE hours is Case Studies & Clinical Pearls 211, and what is the format?
2 CE hours, fully online and self-paced — course video with case walk-throughs plus downloadable handouts, followed by an assessment. Your certificate is available in your account immediately upon completion, and enrollment includes one year of access.
My patient has a large disc herniation on MRI — when does that become a surgical case?
That is the sequestration protocol, and it is one of the two cases this course is built around. The course teaches the neurological indicators that mark the clinical tipping point — the findings that still allow conservative management, and the ones that demand immediate neurosurgical intervention — so the referral decision is defensible either way. The companion pearl covers Modic Type I versus Type II changes, which change your adjustive force, your frequency of care, and the prognosis you communicate. No prerequisites; the series may be taken in any order.
Is this course accepted for my state's chiropractic license renewal?
Case Studies & Clinical Pearls 211 is a PACE Provider #34015544 program co-sponsored by Texas Chiropractic College and is accepted in most U.S. states plus the District of Columbia and Puerto Rico, six Canadian provinces, and more than 50 international jurisdictions. The complete approval list appears at the bottom of this page, and your state's online-hour rules are summarized in its CE guidelines page.
How do discounts and certificates work?
Courses are $20 per credit hour, and discounts apply automatically in a single order — 10% off at 6–9 hours, 20% off at 10 or more. No promo codes. Each completion generates an instant certificate with a permanent copy in your account dashboard, and CE Broker reporting is handled automatically for states served.
State Approval and Licensing Reminder
Continuing education requirements — including online-hour caps and clinical-hour minimums — vary by jurisdiction. Review the online chiropractic CE guidelines page and contact CCEDseminars with questions about your specific licensing requirements before registering.
Ready to Enroll in Case Studies & Clinical Pearls 211?
2 CE hours · $40 · online & self-paced · instant certificate. Add it to your cart, or pair it with 212 to follow the second pass down the lower extremities.
CCEDseminars · PACE Provider #34015544 · Reviewed by Monte Horne, DC · Last updated September 3, 2026 (CT)