I was never offered Ketamine infusions, but I would SURELY ask about that before allowing them to do ANY more injections into the spinal canal. All those are, are money makers and just "bandaid" fixes. Perhaps the ketamine infusions weren't even available when I had my problems -- it was awhile ago.
Tramadol didn't do squat for me either. LOL All it did was make me have a real MIGRAINE! Good Lord, that was awful.
Ask about a long-acting Opiate -- although if he has you on Tramadol, he probably won't give you any. But you DO need something long-acting! You need something that lasts at LEAST 8 hours or so. I'm on OpanaER and that works quite well. It does last close to 8 hrs and I sure appreciate that!
Keep us posted, okay? Keeping you in my prayers. Hugs, Lee