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Review
. 2005;28(5):426-31.
doi: 10.1080/10790268.2005.11753843.

Spinal hydatid disease: a case series

Mukund M Prabhakar  1 , Apurv J Acharya, Dhaval R Modi, Bhavin Jadav
Affiliations
Review

Spinal hydatid disease: a case series

Mukund M Prabhakar et al. J Spinal Cord Med. 2005.

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.

Conclusion: 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.

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Figures

Figure 1
Figure 1. Sagittal view, T2-weighted MRI scan of the thoracic spine showing multi-level involvement by numerous hydatid cysts with spinal intrusion and penetration of surrounding soft tissue. The cyst fluid appears iso-intense with the cerebrospinal fluid in both T2-weighted and T1-weighted images. There is no mechanical failure of the vertebral column.
Figure 2
Figure 2. (A) and (B) Transverse cut of CT myelogram showing lumbar spine involvement with multiple circular cavities in the body and displacement of the cord caused by soft tissue invasion of the spinal canal by the cysts.
Figure 3
Figure 3. Transverse view, T2-weighted MRI scan showing multiple echinococcal cysts in the body and appendages of the vertebra, with intrusion of the hydatid cysts into the spinal canal.
Figure 4
Figure 4. Perioperative photograph of the fourth patient during posterior decompression of the cord through laminectomy, showing multiple grape-like hydatid cysts bulging through the spinal canal in the center.
See this image and copyright information in PMC

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