ABSTRACT

History:

Hydatid disease of the spine is an extremely rare condition with a poor prognosis that presents diagnostic and therapeutic challenges.

Patients and Methods:

In this study, we present three cases of spinal cyst hydatidosis. The mean age of the patients was 32.3 years, and the mean follow-up time was 4.6 years. The patients were evaluated by clinical, biochemical, and radiological follow-up. The location of the disease was limited to the lumbosacral region, except for one case that showed involvement of both the lumbosacral and the thoracic spine. The spine was exposed in the posterior for all cases. Decompression or curettage and resection of the infected bone were performed. For one patient, an additional fusion with instrumentation was performed after removing the involved posterior elements. During the postoperative period, combined anti-parasitic therapy with albendazole was also given to all patients.

Results:

The outcome was excellent for one case, partial improvement was observed for another case, and no improvement was obtained for the other case. Repeated surgery was necessary for all cases, due to local recurrence or residual cysts.

Conclusions:

Spinal hydatidosis is a locally malignant disease with a high reoccurrence rate. The preferred management strategy is spinal decompression, vertebrectomy and instrumentation in appropriate cases, and postoperative use of albendozole as a chemotherapeutic drug. Even when all treatment modalities are applied, local reoccurrence occurs very frequently. Due to the difficulties of treatment, ideally the disease would be prevented rather than treated, by eradication of the parasites from hosts in endemic areas.