Who is right? Surgeon or tech/radiologist that reads an MRI?

Question

Had lumber laminectomy Feb 20 2007. (2nd surgery on l5s1). Never was out of pain and got worse starting 2 weeks post-op, now with pain down BOTH legs. New MRI showed NEW herniated disk on nerve....The surgeon spent more time today showing me what he cut out, than he did with the problems at hand and said the radiologist sucked and was wrong, there is no herniated disk. Even when I pointed it out on the film, he kept switching back to the picture of where he operated.
I have heard of the people that read the MRI's make mistakes sometimes, maybe miss something. I have NEVER heard of them saying something as big as that is there and it not be. Not only do I see what I beleive is a herniated disk in the pics, but I had and have ALL the clinical symptoms as well...BEFORE the MRI. Seems like the surgeon is afraid I would sue or something. I told him I just need help to get this fixed. He said the pain is DDD and the disk is so thin and I need a fusion, but he is not qualified to do it.

Answer 1

Hi. This is a very common problem in medicine in general. People who cannot agree.
Who is the expert at reading the film---THE RADIOLOGIST....a radiologist is a board certified doctor. That means he specializes in reading these things.
Who is the expert at your back and what to do with it---THE SURGEON......so he might agree or disagree with the radiologist but he is the one who ultimately has to make the decision as to whether or not he will operate.
A "tech" has no right to read an MRI by the way. If the person reading your MRI does not have M.D. or D.O. after his/her name, then that person should not give his/her impression of the film.
I'm sorry about your situation. The best thing to do is to get a second opinion. No one's feelings are ever hurt about a second opinion.
The surgeon might be afraid of getting sued, but you have to understand that his JOB is to decide whether you need surgery or not. He has to accumulate evidence and use his experience to make this decision. If he is not comfortable putting you under the knife, you can't sue him for that, nor would it be reasonable.
It is your obligation to get a second opinion.
I hope this helps. Patients get so confused and it is a very frustrating thing to see that you are confused also. I think a team should be developed in the hospital that does nothing but make sure the patient understands EVERYTHING.

Answer 2

Ugh - I feel your pain, literally! I too had a laminectomy on L5 S1 without fusion (Jan 25, 2007). I am 11 weeks out today and I still have leg pain that I need to control with narcotics and lots of Advil Liqui Gels. When I went into surgery I had left leg pain only. When I came out I had BOTH legs in pain. I am trying like heck to believe that I am going to be one of those people whose inflammation is going to take a long time to calm down. My surgeon says give it a few more weeks and then wants me to have a mylegram done. That will show if there are any other nerves that are compressed. You would think they would do that BEFORE the surgery so that would be able to decompress all the areas that showed a compressed nerve during that initial surgery.
It is very frustrating, not to mention depressing. As far as the reading of an MRI film only a doc should do that. Techs know alot but legally they can get slammed if they counsel a patient or make recommendations to you. Maybe both of us need to find another doc! I think you nailed it when you said your doc kept drawing your attention AWAY from what you could plainly see for yourself was a herniated disc. Patients are much more educated these days and you have a right to question ANYTHING about your treatments. I would seek out another opinion. You can also take your films with you and don't forget to bring the MRI hard copy report and the "operative notes" (your docs narrative about what he did step-by-step) during surgery with you too. The 2nd doc will want to see that also. Good luck to you (and me!)

Answer 3

First of all, if you are that worried about the MRI go get a second oppinion. I had knee surgery and the doctor completely misses that my knee cap was split n half and I had a MRI and 5 x-rays and surgery. Second of all, I work with radiologists at a Hospital. I know that they dictate which mean they read the MRI's,CT's and EKG's and x-rays and colonostomys and etc. First what they do is look at the exam to very carefully and record a report of what they see when the view a patients exam. Half the time when want another oppinion the radiologists call in another doctor and have them look at it from a new perspective. I see these doctor's and they really take the time to make the right decision. If I were you I would ask the suregon if they know of someone that can do this type of surgery. Don't take this laying down. Go out there and find a doctor that wants to take on the challenage.

Answer 4

Have your MRI films read by another radiologist or speak to the radiologist that originally read them and tell him/her that the surgeon disagrees. DDD causes discs to herniate so I don't understand his evaluation. I certainly would consider another opinion and always get a copy of your MRI films that you keep along with the report. So sorry you're having problems, I know it's awful.

Answer 5

I have had 5 surgeries on l4-l5 ending with a fusion. I had a nuerosurgeon and would most definitely trust him with the mri more than a tech. A side note, I have use of my right leg since the fusion but the pain for the past five years has need narcotic medication to control enough to keep up a somewhat normal life. So if you get to that point really think about it, if you can walk and have no urinary or bowel problems really really think before a fusion. good luck.

Answer 6

They both do look over the MRI. Best advice consult with another physician/surgeon and have them read the film. When all else fails a second opinion is best.

Answer 7

stop horsing around with this Dr and get a second opinion