I see a few post regarding MSSA and the chances of recurrence.....but I dont see the answer that I am looking for.... maybe someone can help me...
On Nov 2, 2009 I had a surgery on my T11 - T12 and L1 to remove fiberous dysplasia from my T12 and floating 12th rib on the left side. They removed my rib and the left side of T12. At that time they place a cadavar bone graft into T12 and fused T11-T12 and L1 together. Two weeks later I was in the ER for an infection subcutaneously around the incision site. I had to have a second surgery to clean the infection out on Nov 19th. They closed me up and sent me home 6 days later with an RX for IV therapy 1 time a day for three weeks... They were unable to get a pic line in so I was a pin cusion at the local hospital for weeks.
During this whole time I was in excruciating pain with my back cramping and spasming, practically unable to walk without the pain dropping me to my knees. I went to the my PCP and they gave me Valuim... which didnt touch the pain.
Finally I could take it any more and on Feb 26, 2010 I had a follow up appointment with my neurologist/surgeon and had another Xray only to be told that the infection was now around the bone graft and surgery was needed to clean out the infection again and remove the bone graft and replaced it with a metal rod. 6 days later they released me with a hickman port. 12 weeks of Vanco thru the line 3 times a day for an hour and a half. Then told that I would be on oral antibiotics for 6 months (Cipro and Rifampin ). I had to stop taking the Cipro because of digestive reactions I was getting. They put me on Keflex 4 times a day instead.
As of last week my labs looks "great" all indications of infection are within the normal range for someone without an infection. So they took me off the antibiotics 3 months early..
I am more than a little concerned that this infection is going to come back. I was supposed to have one surgery with a 6 - 8 week recovery and it has now been three surgeries and 10 months of recovery...
Does anyone know the chances (percentage) of MSSA recurrence?
The thing is I now have a "cage" or the hardware around my spine that has a screw sticking out of my back... You can feel the screw, see the screw (under the skin) but I am told that I can have the hardware removed after a year from the original fusion surgery but I am SOOOO afraid of another infection that I am now willing to deal with the discomfort of a screw sticking out of my back instead.
I see that MSSA can come back for up to a year or more??? I will be a total basket case with any unusual twing or pain for the next year if that is the case..
Hi there, it's been quite a difficult year for you! I'm sorry you've had to go through that.
It's difficult to give percentages in this situation, but this situation has less to do with MSSA than it does with the fact you had an infection at a site where there is foreign material.
Let me get one thing straight: when you went back to the OR and had the bone graft removed, that is when they placed the rod there right?
The difficult thing about your situation is that a foreign object was placed in an area which had infection. The surgeons try to clean up as much of the infected bone as possible, but it's not perfect, which is why they gave you an extended course of antibiotics after that. Hopefully that cleared what little infection was remaining. The problem with the bacteria/foreign material is that they can stick to the metal and form a biofilm which antibiotics can't penetrate. This is not always the case, but in a minority of cases it is.
So can your infection recur? Yes. Can I give you a percentage probability? No. Will you have pain when it recurs? Maybe, but probably not. What you need to look for is unexplained fever.
From now on, do not let any doctor give you antibiotics if you have a fever and there is no explanation for it. Make sure you tell them about your surgeries and previous infection and that the area is imaged with a CT or MRI. Giving antibiotics for an unexplained fever in you, could mask the infection if it ever came back.
Keep in mind though, the surgeons do the absolute best they can do remove infected bone, and this should keep your probability of recurrence low.
Thank you Harka for answering my questions... I forgot to mention that I was on Ancef for 6 weeks thru my hickman and 6 weeks of vanco and at week 5 1-2 I came down with a vanco rash all over my body and had to quit taking it early. Thats when they put me on the two oral antibiotics.
To answer yours yes, the 1st surgery the put the bone graft in. The second they left it in there and just cleaned everything out and closed me back up...stating that the infection wasnt around the bone graft at that time and they prefer to have bone heal to bone so they left it in there.
The third surgery is when they removed the bone graft and replaced it with the rod stating it was less likely to have the infection attach to the metal then the bone and with no blood flow to either they thought it safer to place metal rod... Is the infection something that can re-occur anywhere at anytime? My risk doesnt drop over the years?
Thanks again for answering my questions...