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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 34731
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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My father had a syst in the spinal area of his lower back,

Resolved Question:

My father had a syst in the spinal area of his lower back, drained and removed 18 month ago. The surgery went according to the consultants plans and recent CT / Xrays show the surgery has been successful. However, since then an infection has repeatedly returned. Antibiotics of increasing strengths have been prescribed. Each time it is though the infection has gone away my father comes off the anitbiotics. Within a week or two the infection returns and it seems to strike him in the back area where the surgery was performed.
Each time my father goes to the consultant the prognosis is that things are getting better and a continued treatment of antibiotics prescribed.
I have suggested he seek a second opinion but he has not done so to date.
My father is 74 and was in good health and fit prior to this surgery.
Submitted: 6 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 6 years ago.



Following are the causes of repeated infection at the surgical site which is difficult to eradicate till the primary cause is taken care of;


1) An unabsorbable suture; this acts as a foreign body and any infection would not be eradicated in it's presence. So wound would need an exploration and removal of suture.


2) An infection like tuberculosis, which is not uncommon in his age group, and may get better by antibiotics, but would need specific treatment for it. A specific culture for the tuberculosis need to be done to confirm the cause.


3) An infection like MRSA; a culture test identifies it.


4) A sinus formation; this is a pocket of infection and bacteria stay in the cavity underneath the deeper tissue. This also need surgical exploration.


As you mentioned a second opinion may be sought or you may discuss these possibilites with his surgeon.


Please feel free for your follow up questions.


Dr. Arun

Customer: replied 6 years ago.

Various blood tests have been undertaken to try and identify the cause of infection so I hope MRSA, Tuberculosis and/or other infections would have been spotted.


I am not sure what suturs were used but there was a disc replacement and possibly fusing of one spinal joint.


If the original syst had not been fully removed could this also be the source of ongoing infection?

Expert:  Dr. Arun Phophalia replied 6 years ago.



Since the CT scan is normal, a residual cyst is quite unlikely. A cyst would also not be likely to be responsible for the recurrent infection. The sutures are used for closing the soft tissue (muscles and fascia) in the disc surgery and they are not uncommon cause for the recurrent infection.


It is privilege assisting you.


Dr. Arun

Customer: replied 6 years ago.

One last question.

In the UK the NHS advocate a conservative approach/policy and tend to wait and see what happens rather than undertake further surgeries. As it has been 18 months since the operation should e be insisting of a more proactive approach include further exploration or other surgery?

Expert:  Dr. Arun Phophalia replied 6 years ago.

Yes, Definitely. He needs more proactive approach like re-exploration as any further antibiotic course is not much likely to stop the recurrence.


It is pleasure and privilege assisting you.


Dr. Arun

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