Spinal hydatidosis.
METHODS
Retrospective study.


OBJECTIVE
To revise the treatment of spinal hydatidosis.


BACKGROUND
About 50% of cases of bone hydatidosis are spinal.


METHODS
Twenty patients with spinal hydatidosis were treated. There were 13 men and 7 women, with a mean age of 53.1 years. The median follow-up was 4.8 years. The infected area was the cervical spine in 1 patient, the dorsal spine in 7, the lumbar spine in 7, and the sacrum in 5. Curettage and resection of the infected bone were performed. The spine was exposed posteriorly in all but 2 patients. An additional posterior decompression and fusion with instrumentation were performed after removing the involved posterior elements in 8 patients. An anterior approach was used in 2 patients: a total corpectomy was performed and a bone graft was added. Two weeks later, a posterior decompression and fixation with instrumentation was done. No preoperative drugs were used. Medical antihelmintic treatment was used after surgery in all but 8 patients.


RESULTS
Thirteen patients had spinal cord injury at the moment of surgery. The neurologic damage recovered only in 1 case. Repeated curettage was necessary in 13 cases: in 12 of them because of recurrence and in 1 because of surgical wound infection. In 6 cases of recurrence, there was also chronic wound infection. At last follow-up, 17 patients were free of disease.


CONCLUSIONS
The treatment of choice of spinal hydatidosis is surgical removal of the affected vertebrae combined with posterior stabilization, followed by postoperative adjuvant chemotherapy. Recurrence is very frequent.
Herrera
Antonio
A
Service of Orthopaedic and Trauma Surgery, Miguel Servet University Hospital, Zaragoza, Spain. aherrera@salud.aragon.es
Martínez
Angel Antonio
AA
Rodríguez
Javier
J
D000328:Adult; D000368:Aged; D015766:Albendazole / Q000627:therapeutic use; D000969:Antinematodal Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004444:Echinococcosis, Hepatic / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D004445:Echinococcosis, Pulmonary / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D048209:Echinococcus granulosus / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008297:Male; D008463:Mebendazole / Q000627:therapeutic use; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000469:parasitology* / Q000473:pathology* / Q000628:therapy; D013131:Spine / Q000469:parasitology / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
D000969:Antinematodal Agents; D008463:Mebendazole; D015766:Albendazole