A lasting solution is hard to achieve in primary hydatid disease of the spine: long-term results and an overview.
METHODS
Retrospective evaluation of patients with primary hydatid disease was done, with an overview of the pertinent literature. OBJECTIVES.: To determine the results of surgical decompression and antihelminthic treatment.


BACKGROUND
Bone involvement in hydatid disease has been reported to be only 0.5 to 4%. Spinal involvement is found in 50% of these cases, with mortality over 50%. Paraplegia is the most serious complication of the disease, caused by compression of the spinal cord by the cysts. Aggressive surgery combined with antihelminthic therapy is recommended to eradicate the disease and prevent recurrence.


METHODS
Three patients with primary spinal hydatid disease were operated on several times for multiple recurrences. Combined chemotherapy with either mebendazole or albendazole was also given. The mean age was 52 years, and the mean follow-up time was 92 months.


RESULTS
Surgery and chemotherapy improved the symptoms in all cases but could not prevent recurrences and multiple operations.


CONCLUSIONS
Primary spinal echinococcosis must be considered in the preoperative differential diagnosis of the atypical presentation of vertebral lesions, especially in patients with risk factors. Early diagnosis and preferably anterior radical surgery combined with antihelminthic therapy of sufficient duration are mandatory to at least halt the progression of symptoms, but these measures could not provide a lasting solution for the patients described here.
Ozdemir
Haci Mustafa
HM
Department of Orthopedics and Traumatology, Meram School of Medicine, Selçuk University, Konya, Turkey.
Ogün
Tunç Cevat
TC
Tasbas
Bülent
B
D000328:Adult; D000368:Aged; D015766:Albendazole / Q000627:therapeutic use; D000871:Anthelmintics / Q000627:therapeutic use; D001416:Back Pain / Q000209:etiology; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004443:Echinococcosis / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000469:parasitology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008463:Mebendazole / Q000627:therapeutic use; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D019635:Neurosurgical Procedures; D011859:Radiography; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012447:Sacrum / Q000000981:diagnostic imaging / Q000469:parasitology; D013122:Spinal Diseases / Q000175:diagnosis* / Q000469:parasitology / Q000628:therapy*; D016896:Treatment Outcome
D000871:Anthelmintics; D008463:Mebendazole; D015766:Albendazole