|It appears your surgeon to see has been in practice 23 years. That is too long ago in residency for doing a orthopedic spine surgery fellowship. So, he has general orthopedic training unless he managed to do a spine fellowship somewhere along the way.
As for the epidural injections: if they used fluoroscopy with dye (radio-opaque contrast), then you probably had a good block. If it did not work under those circumstances, it will not work under any circumstances assuming the guy doing the block was aware of the need for the contrast dye to spread to the area of pathology. If no fluoro or no contrast, then consider repeating the epidural via a transforaminal route performed by a pain physician.
|I agree a second opinion from a NS may be in order. The epidural administration of drug probably did not work because it was not targeted to the disc level and the massive volume used during injection diluted out the steroid all up and down the spine so that only a small fraction was deposited on the affected nerve. A transforaminal small volume approach would have avoided this and placed the majority of the drug directly on the nerve. Also, the automatic planned repeat in 2 weeks of another epidural steroid injection has no basis in medicine or science. The depressive effects of the steroid on the adrenal glands from the first injection would not have worn off by 2 weeks, and repeated high dose steroid injection (120mg is fairly high) can lead to shock or severe systemic effects (short term for about a week) after the injection. Because of these two issues, I question whether your steroid injection was optimally performed, and therefore your poor results may be due to the choices made by the anesthesiologist. A pain physician would probably not have used this method. If your FP selected the anesthesiologist and now has selected your spine surgeon, it may be that the FP is not sophisticated enough to know the differences in practice, and referral patterns may be based on who one knows rather than what one knows. Consider a second opinion by a neurosurgeon OF YOUR CHOICE, not that of your FP.
Muscle spasms are not uncommon due to the irritation of the spinal nerve....the posterior part of the nerve courses to the muscles of the back and the anterior (front) part of the nerve goes to the leg.