I can tell you that neuros have at least 2 years more training than orthos.
Sorry you are in tons of pain.

I agree, Eric. It makes me crazy when someone insists that a neurosurgeon is more qualified than an orthopedic spinal specialist. The only way that is true is if he is also going to operate on the patient's brain at the same time!! GGRRRRRR!

There are some poorly trained specialists within both specialties. But to make a blanket statement that one group is more qualified than the other is inaccurate.

There -- I got that off my chest.

Now to the problem at hand: I have no idea why your surgeon could not get the needle into the right location. Many surgeons today leave the smaller procedures such as nerve blocks, injections, etc. to the interventional pain medicine doctors, physiatrists and anesthesiologists. They have a lot more practice at it as that is primarily what they do all day. I trust your doctor was doing this under fluoroscopy. If so, I cannot imagine why he couldn't get the needle placed where he wanted it.

This is not an experience you should be having to repeat.

I would imagine that the doctor will have a surgical suite-type room where he does procedures that is well-equipped, if he does it at his office. There is usually a recovery room where you can be watched and/or monitored after a procedure as well. Why don't you call and get some information about the place and check out the doctor's qualifications before you let him stick needles in your spine?

Again, was the surgeon doing your procedure with fluoroscopy? He should have been able to see exactly where he was putting the needle...I just find this very odd. Of course I'm not a doctor, so it may just be something I've never heard about or read about previously...but I've had many nerve blocks and injections and can watch the doctor guiding the needle to the location he wants...and I hear the talking between him and the tech. who is running the fluoroscopic machine...and it sounds pretty clear-cut to me!! I can't imagine that your anatomy is that unusual!! I would be worried that he would have trouble getting things lined up during the fusion....

Take good care,

Gwennie

That is a good point. I assume he was using fluoroscopy, but now you got me wondering they had some type of machine over me and he would push the needle in and he would say lateral and then it sounded like the machine was taking a pic sometimes he would say wiggle and they would wiggle the machine.You got me thinking now, I will have to figure out if it was fluoroscopy or some sort of xray ? I have 12 needle holes kinda in a circle and a few more in the area.Wow this event could have been a good thing as it might give me the info needed to decide what doc not to use for the fusion :& . Yea I can't imagine that my anatomy is that unusual ether if it was I would think it would show up on the mri ? But it could be possible ,I rember having the same kinda problem with an esi.I think their is a debate going on about some people having extra nerves around the disc or somthing,an ortho told me about it a few years ago.

Sounds like they used flouroscopy (xray guided type machine). When I had my Disco a pain Doc did it and they had a hard time with me as well (took 2 hours for 4 puntures- I remeber looking at the Xray thing seeing all the needles in) and it was the miserable. He did hit a nerve and my leg jumped big time. I ended up having a single level fusion at L5-S1. My anatomy seems messed up too I have had at lease 4 nerve blocks and 2 ESIs in different levels/areas and NONE took and I end up in worse pain afterwards, The only injections that have ever worked for me are the ESI SI joint injections. Even when I had my baby the Epedural didn't work right- the OB thought it was weird (I didn't have pain but I felt EVERYTHING and I could still move around fine).

Good luck and let us know how it went.

Thanks, I wonder what is not normal about my anatomy, I would guess it would be the nerves ,if that could be the case, I wonder if some of my pain could be from to many nerves or their placement,just when I think I got this stuff figured out somthing changes the whole game ,I wish I could just go to a doctor and just say fix me and just trust them to fix the problem,but when you go to three doctors and they all disagree on what to do ,it makes you think.

I had mine done twice. I had hardware L4-S1 and he was aiming for the L3 and L3 disc. Only after CT did they realize he his L1 and L2. So two day later I had it done again. These were done by an interventinoal pain medicine doctor.

My prior discogram in 1993 was done by an Orthopedic Spine Surgeon.

Even fluoroscope is not 100%. They may indeed have had problems visualizing the area they want to get into. Thus a different approach may take different positioning or instrumentation they may not have had at their hands at the very moment they were working on you.

Also, in both cases ('93 and '09) I had them give me light sedation (versed). Enough so that I was awake to respond their questions but also enough that I had some relaxation. Then at the end of the discogram they provided pain pain meds in the IV before getting me up.

I would think the doctor or nurse could have a conversation with you to tell you what they'll do differently this time, and you could ask about light sedation at the same discussion. Keep in mind with even light sedation you must have someone to drive yo home after.

And I was sore for about 2 days after my discogram. It felt like I had a bruise at the site, but my hubby looked and there was no discoloration or bruising at all.

I've had 2. 1 by an Ortho who did my 1st surgery and 2nd by a Pm/Anesthesiologist. This 2nd one I was sent to by my Neurosurgeon who did my 2nd surgery. He doesn't do ESI, Discogram, etc. He sends his patients to the Pm/Anesthesiologist. I have had good results using both. The Ortho did his own ESI, Discogram, Lumbar/Cervical surgery. He did a very good job. The Pm doc did it differently than the Ortho. It hurt a lot more. But he got the info that the Neuro wanted and that locked in the surgery I was going to have.

2 discogram tests in 1 week is crazy. Obviously your surgeon has never had one... After my 1st one I actually felt better a few days later. My pain decreased for a few weeks. The Ortho thought that was crazy, but was glad. He said almost every patient complains of pain for 3-10 days after depending on how traumatic and what got hit. Sometimes it is inevitable to poke something they shouldn't. The 2nd one done by the Pm doc hurt for a week. There is no way I would have let him do it again a few days later.

I was told that if you have a badly twisted spine, are fairly overweight, or a body builder type. Then the test can be difficult. Either excess fat to try and guide through, or too much bulk muscle. Sometimes the visualization just isn't perfect. Sometimes it's just not your turn. I've had myelogram and will never do it again. Must not have been my day. Most folks say they aren't horrible. I disagree.

Ortho vs Neuro again...
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The whole argument about Neuros have more schooling/training so are therefore better than Orthos is ignorant. A spine specialist can be either. Either one can also choose to specialize in a given area and not generalize. That requires extra training over and above their initial degree. College degrees are pieces of paper that let you get in the door. Doesn't mean you'll amount to anything having that paper. I've worked with MIT grads in engineering that weren't worth a $h1t even with a fancy degree...

My spine Ortho was dedicated to lumbar/cervical spine work. His partner did hips and knees only. Other partner did hand reconstruction. All were Orthos, none were generic. My Neuro does not do brain surgery. He is a spine surgeon. He started on cervical and added lumbar later. He is very good at both.