title: Spinal manifestation of hydatid disease: a case series of 36 patients.
abstract: OBJECTIVE
  Vertebral hydatid cysts are found in <1% of all cases of hydatidosis. The pathology has an infiltrative malignant nature, affecting the vertebral body with possible extension in the epidural space. This pathomechnism is associated with a high rate of morbidity, mortality, and relapse. Decompressive surgery combined with antihelminthic therapy is recommended to eradicate the disease and prevent recurrence.
  
  
  METHODS
  Between 1990 and 2007, 36 patients with a mean age of 31 years were diagnosed as having spinal hydatid disease and underwent surgery on several occasions for multiple recurrences. Combined chemotherapy with albendazole also was given.
  
  
  RESULTS
  Initial surgery and chemotherapy steadied clinical progression and functional deterioration, but with a recurrence rate of 89% and an average time to disease recurrence of 2.5 years, did not improve the known malignant course of disease in comparison to the literature.
  
  
  CONCLUSIONS
  The devastating and malignant course of this disease, which affects mostly young patients, demands continuous development of preventive care in endemic regions, the early detection and screening of the diseased patients, and eventually the advancement of the combined medical and surgical treatment.
authors.affiliation: Department of Neurosurgery, Nahraine Medical College, Baghdad, Iraq.
authors.forename: Abdulameer
authors.initials: A
authors.lastname: Kafaji
authors.forename: Tarek
authors.initials: T
authors.lastname: Al-Zain
authors.forename: Johannes
authors.initials: J
authors.lastname: Lemcke
authors.forename: Ferass
authors.initials: F
authors.lastname: Al-Zain
mesh_terms: D000293:Adolescent; D000328:Adult; D015766:Albendazole / Q000627:therapeutic use*; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002648:Child; D019299:Decompression, Surgical; D004443:Echinococcosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000469:parasitology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000981:Antiprotozoal Agents; D015766:Albendazole
keywords: CT; Computed tomography; Echinococcus; Hydatid cyst; Hydatosis; MRI; Magnetic resonance imaging; PMMA; Polymethyl methacrylate; Spinal hydatid; Vertebral hydatid