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    Senior Member Zeus's Avatar
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    Removal of Infected Fusion Rod?

    I haven't posted here in a long time, mostly because I've been caught up with everyday life etc, but as some of you know I had my SCI when I was 7 years old and am a C5 complete quad. When I was 18 I had a complete spinal fusion from T1 to L5, to correct the severe scoliosis most paediatric SCIs develop.

    In 2016 I had severe leg spasms which necessitated a Baclofen pump which was ultimately removed because I developed a massive CSF leak. They had to drill a hole in my vertebrae to get the pump epidural needle into my spinal canal, because I had so much bone growth around my vertebrae over the years, which was bigger than the needle and a perfect place to spring a leak. To make a long story short, after 4 surgeries I learnt that I could control my leg spasms by taking 5 mg of Valium twice a day and 10 mg of Baclofen 4 times a day – 4 surgeries for nothing.

    The real downside was that they gave me an infection during those procedures, and in the 4th surgery found puss on my Harrington Rod which they immediately washed out with saline infused with Vancomycin. They also put me on one month of IV antibiotics and 6 months of oral antibiotics – everybody crossed their fingers and hoped for the best (i.e., that the infection was caught early enough that a biofilm had not formed on the rod).

    At the start of this year a cyst appeared on my back and I thought nothing of it, given it had been almost 3 years since my surgeries and I assumed I had escaped a biofilm – how wrong can you be. After cleaning out the cyst, my surgeons found a sinus that tracked all the way down to my rod. They gave me one month of oral antibiotics and basically told me that they will see how long it takes to come back before deciding what to do next.

    Of course 2 months later the cyst is back already and I am faced with 2 choices – removing the rod or considering long-term suppressive antibiotics. Apparently I have a very low virulent strain of pseudomonas coating my rod, so I have taken one week of left-over Ciprofloxacin that I had and the sinus has immediately closed. Now that I have run out my surplus antibiotics I can feel fluid building up under the skin already.

    I know most doctors are hesitant to prescribe long-term suppressive antibiotics, but at the same time my surgeons have said removing the rod will be '10 times' harder than inserting it was because it is now coated with a significant amount of bone. To put it bluntly, they need to chisel a significant amount of bone away in order to remove the rod, but given that my spine is well and truly fused after 26 years I won't need another rod inserted. I am waiting to speak to my head surgeon about the details of the surgery, but I understand that the surgery will be difficult while my recovery should be fairly smooth given that I won't be waiting for any bones to fuse etc (assuming nothing goes wrong again, like becoming septic during a surgery where an infected rod is exposed to your blood supply).

    I guess I am wondering if anyone has had a similar situation, or if the spinal nurses have faced a similar situation? Given that I am 44, do I get the rod removed or do I look for long-term suppressive antibiotics and take the risk of complications down the track? I had 4 surgeries in 2016 that were a complete failure, so I am not exactly thrilled at the idea of another major surgery. What really irks me the most is that my spinal specialist never thought to try Valium and Baclofen at the same time, which have worked amazingly well for me (from crazy spasms to almost 0 in a week). I could have avoided 4 surgeries and an infection in my rod.

    Any suggestions or thoughts are most welcome. Heck, even as a person that is not particularly religious I'm open to thoughts and prayers at this stage...

    Chris.
    Last edited by Zeus; 07-07-2019 at 07:53 AM. Reason: Typos!
    Have you ever seen a human heart? It looks like a fist wrapped in blood! Larry in 'Closer', a play by Partick Marber

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