Post OP MRI showing surgery possibley on the incorrect side.
2025.01.18 05:47 badrn Post OP MRI showing surgery possibley on the incorrect side.
Hello, I had a right-sided laminotomy last year, but unfortunately, it did not improve my condition. A post-operative MRI reported that the procedure was performed on the left side instead. I requested an overread from the imaging office, but the results remain inconclusive. My surgeon is confident the surgery was done on the right side, as evidenced by scarring visible on the MRI. Additionally, the pre-operative MRI did not indicate any laminar thinning on the left side.
I like and trust my surgeon and don’t want to offend him, but I’m facing the possibility of a spinal fusion and want to be absolutely certain the laminotomy was done correctly before moving forward with such a life-altering procedure. Would it be reasonable to request a CT scan to confirm the results? This situation is further complicated by being a workers’ compensation case.
MRI report: At L5-S1, postoperative laminotomy on the left. Chronic asymmetric right-sided disc bulge with endplate osteophytes that extends into the neural foramen on the right not significantly changed. Moderate facet arthropathy on the right. Severe right neural foraminal stenosis with moderate effacement of the foraminal L5 nerve root is stable to slightly progressed from comparison MRI.
ADDENDUM: Addendum request to clarify site of laminotomy. Technically challenging exam due to body habitus and patient motion on axial sequences. As stated on the initial report, there appears to be a left L5-S1 laminar defect. This may simply represent laminar thinning particularly with a provided history that no laminotomy has been performed at this site. On the right there is ill-defined low signal in the location of the right lamina as well as extending into the adjacent dorsal paraspinal musculature. Although some of this low signal mimics bone, in the setting of prior surgery, this could represent a laminotomy with fibrosis. This is supported by the high STIR signal in the dorsal paraspinal musculature. These findings could be clarified with a CT lumbar spine to assess the bony architecture. There is low signal in the the right lateral recess at L5-S1, which could represent recurrent disc versus fibrosis. This cannot be differentiated without postcontrast MRI. However there is only mild right lateral recess effacement due to this finding. As stated on the initial exam, there is severe right L5-S1 foraminal narrowing which appears to be due to a disc osteophyte complex.
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