Spine Surgery

For Counsel · End-to-End Workflow

From a box of records to closing argument.

Four services, one continuous engagement. Click any stage to see what an attorney actually needs at that point in the case — and what is delivered.

Stage 00Intake & triage

The Box of Records

What the attorney needs

You receive thousands of pages of records, imaging discs, and operative notes you cannot meaningfully read. You need to know what actually happened — before you decide how to litigate it.

The unsorted record is reorganized chronologically by clinical event — pre-injury baseline, mechanism, presentation, imaging, operative course, complications, recovery, residual deficit. Nothing is opinion yet. This is just so both sides are looking at the same case.

  • Chronological clinical timeline
  • Imaging index keyed to dates and findings
  • Gap list — what is missing or inconsistent
Live · Stage 00
Stage 01Service 01 — Analysis & Narrative

Record Analysis & Clinical Narrative

What the attorney needs

You need to understand what the medicine actually shows — in language a jury can follow — and you need to see the strongest version of both sides before you commit to a theory.

A plain-language narrative of what the records show, with both the plaintiff-favorable and defense-favorable reading laid side by side. Where helpful, 3D reconstructions and surgical animations are commissioned to recreate the mechanism, the anatomy, and the operative decision.

  • Layman's clinical narrative (both sides argued)
  • Annotated imaging and operative figures
  • Optional 3D / animation recreations of the injury and surgery

Worked example · Both sides argued

A single record fact, read two ways — then read honestly.

Hypothetical: 38-year-old, low-speed rear-end collision, new T12 compression fracture on a previously degenerative spine. Select a record fact to see both framings.

What the record says

Pre-crash lumbar MRI (14 months prior) shows multilevel degenerative disc disease at L4–L5 and L5–S1. Post-crash CT shows a non-displaced T12 compression fracture with ~15% height loss; surrounding bone is osteopenic on DEXA.

Plaintiff reading

The patient was working full duty before the crash. The new T12 fracture is not on the prior imaging. The degeneration below is a separate, asymptomatic finding. A previously functional spine became a fractured spine on the day of the collision.

Defense reading

This is a degenerated, osteopenic spine. A 15% height loss in a low-energy mechanism is consistent with an insufficiency fracture that could have occurred from a cough, a lift, or a fall. The MRI tells you this spine was already failing.

Surgeon's synthesis

The fracture is new. The bone quality is poor. Both are true. The honest question is whether the collision forces were sufficient to cause this fracture in this bone — not whether the bone was perfect.

Live · Stage 01

Plaintiff reading

Defense reading

Surgeon's synthesis

What the imaging, mechanism, and operative notes actually support — and where each side's theory breaks.

Stage 02Service 02 — Rule 26 / State-Compliant Report

Written Expert Opinion

What the attorney needs

You need a report that conforms to Rule 26 — or the applicable state expert disclosure template — and that will survive Daubert. You are not looking for help drafting it. You are looking for the surgeon to actually write it.

Self-authored. Reasoned. Cited. Each opinion stated to a reasonable degree of medical certainty, with the methodology and literature exposed so opposing counsel cannot strip it on a reliability challenge.

  • Federal Rule 26(a)(2)(B) report, or state-template equivalent
  • Opinions, bases, and supporting literature
  • Qualifications, prior testimony, compensation disclosure
Live · Stage 02

Fed. R. Civ. P. 26(a)(2)(B)

Expert Report of Ahmer K. Ghori, MD

§I. Qualifications
§II. Materials Reviewed
§III. Opinions
§IV. Bases & Methodology
§V. Literature Cited
§VI. Compensation
— A.K.G.
Stage 03Service 03 — Deposition Testimony

Deposition

What the attorney needs

You need an expert who holds the record under cross — calm, precise, and unwilling to be pushed past what the medicine actually supports.

Composed and methodical. Complex spinal anatomy and surgical decision-making translated for the record without overstatement. The opinions in the room are the opinions in the report.

  • Pre-deposition strategy call with retaining counsel
  • Direct or cross testimony, in person or remote
  • Errata review and post-deposition debrief
Live · Stage 03
QDoctor, isn't it true the degeneration pre-existed the crash?
A · Dr. GhoriThe pre-injury film shows degeneration. The post-injury film shows a new fracture.
QCould the fracture have occurred spontaneously?
A · Dr. GhoriIn a 38-year-old, without prior pathology, that is not a probable mechanism.
Stage 04Service 04 — Trial Testimony

Trial Testimony

What the attorney needs

You need the jury to actually understand the spine, the surgery, and why one side's story fits the facts and the other does not. You need an expert who will travel.

Direct and cross examination, demonstratives, and jury-facing explanation of anatomy, mechanism, standard of care, causation, and damages. Available to travel.

  • Trial preparation with counsel and demonstratives team
  • Direct, cross, and redirect testimony
  • Travel — domestic, on reasonable notice
Live · Stage 04
Twelve people. One explanation.TRAVEL · AVAILABLE

For Counsel · Jury-facing demonstratives

Two recurring spine disputes. One transparent way to walk a jury through them.

Both demonstratives use an equal-brick model: every accepted fact doubles the odds, so the math stays visible. Useful for direct examination, cross preparation, and mediation breakouts.

Demonstrative A

Wrong-level localization — counsel demonstrative

Fictional spine case. The dispute is whether the surgeon operated at the intended level — or whether intraoperative localization failed. Walk a jury through the gates that decide which story fits.

Story A · Localization failure

The level treated did not match the preoperative target because the marker image, the counting method, or the time-out verification failed.

Story B · Correct-level surgery

The correct level was treated. Apparent mismatch is explained by transitional anatomy, image labeling, or retrospective interpretation.

Neutral jury question

Which explanation best fits the anatomy, the sequence, the imaging, and the clinical course?

Decision gates

Click each gate to cycle through unresolved → fits Story A → fits Story B. This is a thinking tool, not a verdict.

Evidence-fit model

This is not a win probability. It is a transparent story-fit scale. Each accepted fact doubles the odds in favor of Story A — every fact weighted equally, so the math stays honest.

Starting fit · Story A

50%

Story A fit · equal-brick model

50%

Select facts only if the assumed record supports them.

Story A chain

Pre-op target
Ambiguous counting
Marker mismatch
Wrong level treated
Symptoms persist

Story B chain

Pre-op target
Correct counting
Marker confirms target
Correct level treated
Symptoms explained otherwise

Neutral deposition spine

  • What was the exact target level before incision?
  • How were levels counted in the presence of anatomic variation?
  • Where is the intraoperative image proving the target level?
  • Does postoperative imaging match the level named in the consent and plan?

Fictional spine demonstrative · No real parties, records, or legal conclusions.

Demonstrative B

Injection neurologic injury — counsel demonstrative

Fictional spine case. The dispute is whether a transforaminal injection caused nerve injury — or whether symptoms reflect preexisting and progressive radiculopathy.

Story A · Procedure-related nerve injury

Immediate electric pain, a new deficit, and imaging/EMG findings fit a needle-path or injectate-related nerve injury.

Story B · Preexisting / progressive radiculopathy

Symptoms reflect the underlying disc and stenosis condition. The procedure was technically appropriate; later deficits represent disease progression.

Neutral jury question

Which explanation best fits the anatomy, the sequence, the imaging, and the clinical course?

Decision gates

Click each gate to cycle through unresolved → fits Story A → fits Story B. This is a thinking tool, not a verdict.

Evidence-fit model

This is not a win probability. It is a transparent story-fit scale. Each accepted fact doubles the odds in favor of Story A — every fact weighted equally, so the math stays honest.

Starting fit · Story A

50%

Story A fit · equal-brick model

50%

Select facts only if the assumed record supports them.

Story A chain

Baseline normal strength
Needle event
Immediate electric pain
New deficit
Objective nerve injury

Story B chain

Preexisting radiculopathy
Technically appropriate injection
Symptoms fluctuate
Disease progression
Later deficit unrelated

Neutral deposition spine

  • What was the baseline neurologic exam immediately before injection?
  • Where exactly was the needle tip on the saved image?
  • Did the patient report electric pain during needle placement or injection?
  • What objective test best matches the timing and level of the alleged injury?

Fictional spine demonstrative · No real parties, records, or legal conclusions.

Engage

Send the records. Get an independent surgical read.