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Epidural Injection Done without fluoroscope???

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:27 AM in Lower Back Pain
I was given my 3rd in a series of 3 Epidural Steroid Injection (ESI) without the benefit of the neurosurgeon using his fluoroscope. When I was on th table the machine went down and would not reboot. As I waited (nervously), the doctor and nurse fried frantically to reboot it to get it working. After a couple of tries, the doc says "well I can do this without the fluoroscope - I don't need it". I was scared, nervous and didn't know what to do, so I stayed on the table and he did it. It was much more painful than the first 2. I had a lot of trouble afterward and whatever progress I may have made disappeared and it has been extremely more painful since - escalating to him telling I need a TLIF (after a discogram was also done).
My questions is should I talk to a lawyer about possible negligence? I was not given a choice for continuing the procedure. He just made his statement and then performed the injection. Is this typical? He didn't even hesitate. The doc only seemed concerned about his room full of patients. The injection substantially escalated what I was feeling - which was painful to begin with.
Any help would be appreciated.
bwhite120262@yahoo.com or whiteb@hssd.net


  • I don't think a Anesthetist uses a flouroscope when he does an epidural for a pregnant woman. Unless things have changed lately. I had 2 epidurals with 1 PM Anesthetist and another with my 2nd Pm Dr. They never used flouroscopy. If you feel that you're injured it's up to you whether you contact a lawyer. I had all 3 of my epi's done with no problems thank goodness. I never even heard of flouroscopy use with epidurals until I came here. I've had relief of sciatica of my leg and foot pain and numbness and tingling about 80% and the last injection was Dec. 6. I hope you're doing okay. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • I personally would never undergo an epidural or nerve root injection without fluoroscopy. If the doc thinks he's that good, well great for him but I don't want him. Also, injections can be diagnositc as well as therapeutic. Using fluoroscopy may help light up(with dye) something that doesn't show up as well on MRI.

    As far as legal issues, that has to be your decision and depends on your state. Was it crummy that he went ahead and did it? Maybe, but you would have to probably prove permanent damage and prove that he violated the standard of care. As others have mentioned, there are docs who do it without guidance and use their professional judgement. You would need to speak with an attorney but I think you won't get anywhere with it.

    If you are concerned about his skills, I would report him to either his state's dept. of professional regulation or if in a large group practice, contact their risk management department.

    I think your first priority should be in getting the medical help you need. If you do not feel comfortable with this guy, then you need to find a 2nd opinion as far as surgery. If his attitude is something you feel is not serious about your condition, then I would consider finding someone else to do the surgery.

    Good luck to you, keep us posted.
  • I had a very similar prolcedure with very similar results. Did you get anywhere? Did you pursue legally? Did you find relief? How are you doing now? Did a DR find the source of the pain and is it treatable?
  • ESI is method that any SERIOUS neurosurgeon will proceed by using a flouroscope.

    It is easy possible that he made an error because he has not used flouroscope...
  • dilaurodilauro ConnecticutPosts: 9,865
    better interest of the doctor, many times not a neurosurgeon to NOT perform the ESI without the aid of a fluoroscope!
    With malpractice cases and such, if something when wrong during the Epidural Spinal Injection to a Lumbar, Thoracic or Cervical region that could be isolated to improper techniques, that could create quite a law suit
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I have had ESi's with & without the florscope (it think if that is actually with real time xrays & contrast dye) & although the ones with have worked better as they know exactly which spot to hit rather than trial & error, the ones without haven't hurt me in any way they just haven't been quite as effective. Hope you get some relief at some point.
  • didn't mea to reply to your message, meant to post to the main one DB!!LOL
  • Well, I hope that you have long since resolved your pain issues since the first post was back in January...but...just wanted to chime in...

    I am a medical assistant for a doctor who performs about 20 -30 ESI's a week. She uses Fluroscopy to make sure that the steroid is going into the correct area. Be it L5, L4...S1...whatever...she only wants to make sure that the steroid is getting where it needs to be to ease the patients pain. If you had pain after it was done without fluroscopy...it was probably just because the steroid did not make it to the source of your pain.

    Sometimes...an injection will not work for a patient and she will do the injection in a different area.

    Charry...as far as having an epidural for labor and fluroscopy was not used....while your intention is correct...in that the posters pain was not from lack of fluroscopy...just to set the record straight....epidurals for labor are used to numb below the waist...so...it is not a matter of making sure it gets into the right joint area.

    While our C-arm has not shut down us (knock on wood) I am quiet certain that the doctor I work for would not proceed if that were to happen...but ONLY because it would be a waste of time/ steroid if it did not get into the proper joint to begin with.

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