Expert Review & Medical-Legal Consultation
Dr. Calancie provides independent expert review in selected cases involving neurological deficits after spine surgery.
His background in spinal cord injury, intraoperative neuromonitoring, Motor Evoked Potential testing, EMG, and pedicle screw stimulation makes him well suited to evaluate complex surgical events in which a patient awakens with a new postoperative neurological deficit.
The purpose of this work is to provide clear, evidence-based interpretation of the available neurophysiologic and clinical record.
Areas of Review
Dr. Calancie’s expert review may include assessment of:
Intraoperative neuromonitoring records
Motor Evoked Potential responses
EMG activity during spine surgery
Pedicle screw stimulation data
Alarm criteria and warning signs
Timing and possible mechanism of neurological injury
Relationship between intraoperative events and postoperative deficits
Spinal cord injury prognosis and recovery potential
Intraoperative Neuromonitoring Interpretation
Many spine surgery cases involving postoperative neurological deficits depend on careful interpretation of the intraoperative neuromonitoring record.
Key questions may include:
Were there changes in MEP, EMG, or other monitoring signals?
Were warning signs present?
Were the warning signs recognized?
Were the responses to those warnings appropriate?
Is the pattern of change consistent with a particular mechanism of injury?
Does the record support or fail to support a causal relationship between surgical events and postoperative outcome?
Dr. Calancie’s experience developing and validating neuromonitoring approaches provides a strong foundation for this type of review.
Pedicle Screw Placement and Neural Injury
Dr. Calancie has particular expertise in the use of stimulus-evoked EMG and pulse-train stimulation for evaluating pedicle screw placement during spine surgery.
This experience is relevant in cases where a postoperative deficit may involve:
Medial pedicle wall breach
Nerve root irritation or injury
Spinal cord compromise
Screw trajectory or placement concerns
Interpretation of stimulation thresholds
Adequacy of intraoperative feedback
His laboratory’s work in this area included development of monitoring methods and a randomized, blinded clinical trial evaluating pulse-train stimulation during thoracic pedicle screw implantation.
Independent, Evidence-Based Opinion
In medical-legal matters, Dr. Calancie’s role is not to advocate for a predetermined conclusion. His role is to evaluate the record and provide an independent opinion grounded in neurophysiology, surgical monitoring principles, and the available clinical evidence.
This may include identifying what the data support, what they do not support, and where uncertainty remains.
Professional Inquiries
Requests for expert review may be directed through Dr. Calancie’s professional contact information. Cases are considered selectively, depending on subject matter, available records, and potential conflicts.