hi, thank-you for providing the brief history of you. secondly I a. sorry to hear you have to go through all this pains. let s come to the point now. as you mentioned you have undergone two spinal and one TWR I would have been happy if more about the functional status of you was mentioned. As to this getting spasm, I feel it should be muscular initially. as the muscles of the wrist post replacement needed more attention. Also, taking up an x-ray would have been better to understand more of the joint positioning. Also, how long did you undergo physcial therapy rehabilitation plan? as per my view you should go for longer than expected. Also, indeed you got operated for spine twice, but how much time you performed the physical therapy post surgery? physical therapy is a scientific and secure way to rehabilitate the muscle and movements. also, I will say too look for a physical therapy now as to which he will assist you to further. Meantime you can surely take an appointment with a neurologist, as every experts advice will play a role. May be the use of diagnaotics will come into role as technology has helped alot to rule out human body illness to a greater extent. but hardly we understand the best use of technology used in assessing the human body. okay, your muscle spasm is of what kind? that is important. First you need to reduce the muscle spasm by hot water fermentation and whirlpool therapy. you may have to spend a little time in this process as The muscle relaxation will take some time. I will say that you visit a physical therapist so by which your treatment starts. with the grace of God I wish you a speedy recovery