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latest update on my recovery post infected hardware removal



  • Bedawgs - I had plenty of normal blood tests over the last year - they aren't the only indicator of these sort of infections. I tended to get pain spikes associated with a fever, but did have both independent of each other. The trouble is that these bacteria form a biofilm that your immune system doesn't detect so, of course, bloods can be normal until the next "break out". That's not to say that you have an infection, of course, this has just been my experience. I have done a lot of reading about these biofilm bacteria over the last few months - not a lot else to do!! ;)

    Emily - yes, the surgeons aren't very good at saying what they really mean! His words were "you can go back to doing what you want" but what he meant was "only a little bit"!! I am being very careful because I want to get better, finally. I know that although he says I have "solid" fusion the second opinion chap I saw suggested I only had a little bit of fusion - right across but only one bit. So I am being careful not to overdo too much and hope that maybe now the infection has gone some bone may grow. I am not sure if it can but we will see!
  • I have had a PLIF in June 2011. Now I have chronic osteomyelitis. I have had hardware removal with retention of Cages. Now I am on indefinite Bactrim.

    My conundrum is that my infectious disease MD, thinks the cages might be the foci for my chronic osteomyelitis. She talked to my surgeon about pro's and cons of removing the cages. He noted removal would be difficult as it would require an anterior approach. (I don't know what means)

    So I am on chronic Bactrim. Pain is not too bad. My worry is it seems I have two management pathways, see if infection can resolve on chronic antibiotics or see if another surgical debridement is possible.

    Can anyone provide a similar situation?
    You do not need to read the below to offer comments to my question
    Perhaps my treatment history can help.

    Two days after surgery, I experienced immediate relief. There I developed a rapid escalation of pain in my lower back (instead of my legs). At the same time my incision was soaking my dressings and bead linen. At week 2-4, at follow up, I had an open wound with puss. My CRP was very high > 11 (my ESR was also high) The surgeon obtained a surface sample of puss to culture; that grew out MRSA.

    He felt the infection was superficial, versus deep, but I do not think he did any other testing to see if I had a deep infection.

    Three months later pain started a steady increase and my CRP and ESR went to 11 and 85. My surgeon felt that I had a Deep infection after-all. I had to have my hardware removed except the cages. I was discharged on the bactrim again and in 6 weeks I developed a rip-roaring deep infection.
    Infectious disease MD's joined my treatment team. They diagnosed the second deep infection. This time, though, I was discharged on IV antibiotics (Vancomycin).After the IV antibiotics, I began my chronic oral antibiotics, 5 months ago. (Apparently it was difficult to tell if I have achieved fusion.)
    That brings me to my request for similar situations and potential prognoses.
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  • Hi,

    wow, how similar our tales began! I developped the same sort of leaking wound - it was so bad that my clothes would be wet so I just wore PJs for 4 weeks! My surgeon decided it was just superficial too.

    I had signs of a deep infection - odd fevers, increased pain - from about 6 months post op but my surgeon kept saying superficial. Any way, long story short, nearly 2 years post op he finally acknowledged that there was infection in there when he took the hardware out and saw it. Mind you he still maintains that earlier fevers etc and the lump on my scar at 9 months post op were superficial!! (need I tell you I have a new surgeon?!)

    I had taken a second opinion last summer and he had suggested that my infection could be in the cages too and he basically said if it was it was going to have to stay there. Like I said in an earlier post in this thread I have read a lot about biofilms and it is unlikely they will be dislodged with IV antibiotics. Of course, OM is caused by biofilm bacteria too.

    I feel so bad for you that it has turned out this way. I really hope they can clear you of this infection. I wish you so much luck. All the best, Helen
  • my story is similar too, got a staph infection after the staples were taken out 10 days after surgery but the surgeon said it was not in the bone graft. I had oral antibiotics for 6 or 7 weeks and then was cut off. He only checked up on my back for 3 months and then went away for 6 months. I did see the dr. who was covering for him 7 mos. after the surgery and he looked at the old x-rays and said everything was fine. All he did was refer me to the pain clinic which took 4 months. Now they tell me I have a lumbosacral disk space infection with nonunion and loosening of implants. They also said there has been marked erosion of the adjacent vertical emdplates at the lumbosacral junction so there is damage to the bones that wasn't there before the operation. I see the surgeon tomorrow and hope he will take out the hardware and try to clear up the infection.
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