Medical decompression of vertebral hydatidosis

Abstract

Study design: A case report from one of the longest follow-up studies of survivors with spinal hydatid disease. This patient was treated with a combination of albendazole and praziquantel chemotherapy; the results of this form of treatment are reported.

Objectives: To demonstrate the efficacy of combination albendazole and praziquantel drug treatment for spinal hydatidosis.

Summary of background data: Although echinococcal infestation in humans is a world-wide problem, it is rarely seen in the United Kingdom. Between 1% and 2% of all cases involve bone, and 50% of these involve the spine. The condition has a reported mortality rate of more than 50%. The average length of survival of patients with echinococcal infestation in Britain after the onset of symptoms is 5 years, and the average age at death is 41 years.

Methods: The patient in this report had undergone multiple spinal debridement operations alongside internal fixation and presented with increasing paraparesis from recurrent disease. Surgery for disease recurrence carries a high risk of mortality. The patient was treated with a preoperative combination of albendazole and praziquantel drug therapy, a novel combination for this condition.

Results: Response to treatment was monitored clinically, biochemically, and with serial computed tomography. No serious side effects were observed. Results were very encouraging. After 2 months of treatment she had improved and was able to walk with the aid of a walking frame; therefore, surgery was deferred.

Conclusion: The combination of albendazole and praziquantel drug therapy appears to be effective in the conservative treatment of patients with inoperable spinal hydatidosis.