title: Spinal hydatid disease: a case series.
abstract: BACKGROUND
  Over the past 10 years, 4 cases of spinal hydatid disease (3 men, 1 woman) were diagnosed and treated at our institution, with an average follow-up of 4 years. Hydatid disease of the spine is a rare condition with a poor prognosis that presents diagnostic and therapeutic challenges.
  
  
  METHODS
  The patients were evaluated clinically, using the latest imaging modalities available in our institution. Decompressive surgeries were performed and the diagnosis was confirmed by histopathologic examination. All patients received long-term antihelminthic therapy with 400 mg of albendazole 3 times daily for 1 year.
  
  
  RESULTS
  After surgery, all patients improved; however, over time, recurrence and residual disease were observed. Two patients had complete neurologic recovery at follow-up at 2 to 3 years, although there were radiographic signs of recurrence. The other 2 patients did not achieve complete neurologic recovery despite anterior decompression; they developed recurrent disease and the neurologic status deteriorated to spastic paraplegia. All patients refused further surgeries for recurrences and 2 patients died of complications of paraplegia.
  
  
  CONCLUSIONS
  Diagnosis was challenging, eradication was difficult, and hydatid disease recurred in all 4 patients. In our experience, morbidity and mortality were high and prognosis was poor.
authors.affiliation: Department of Orthopedics, B J Medical College and Civil Hospital, Ahmedabad, India.
authors.forename: Mukund M
authors.initials: MM
authors.lastname: Prabhakar
authors.forename: Apurv J
authors.initials: AJ
authors.lastname: Acharya
authors.forename: Dhaval R
authors.initials: DR
authors.lastname: Modi
authors.forename: Bhavin
authors.initials: B
authors.lastname: Jadav
mesh_terms: D000328:Adult; D015766:Albendazole / Q000627:therapeutic use; D000871:Anthelmintics / Q000627:therapeutic use; D019299:Decompression, Surgical; D004443:Echinococcosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D048209:Echinococcus granulosus / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology* / Q000601:surgery; D013131:Spine / Q000469:parasitology*
chemical_list: D000871:Anthelmintics; D015766:Albendazole