Abstract
Hydatid disease is caused by Echinococcus granulosus parasite. It is an endemic disease; particularly in many Mediterranean countries. The liver and the lungs are most frequently involved. Bone involvement is reported in 1% - 2% of the cases and about 50% of those are seen in the spine. Herein we report a case of primary spinal extradural hydatid cyst that caused paraplegia due to compression of the dorsal spinal cord and was diagnosed initially as case of lumber prolapsed intervertebral disc. The cyst was only discovered when the patient had progressive paraplegia and the preoperative provisional diagnosis was posterior mediastinal neurogenic tumor causing destruction of the pedicle and lamina of the fifth thoracic vertebra. Fortunately, she regained near full power after surgical treatment of her spinal cyst.
Highlights
Hydatid disease is caused by Echinococcus granulosus parasite
Spinal hydatid disease manifests itself through symptoms and signs related to compression of the cysts on other structures which has no specific pathognomonic symptoms or signs
Full power movements appeared in 4 months post-operatively and her last MRI showed normal dorsal spinal cord with partial distortion of the body of D8-9 (Figure 4)
Summary
Hydatid disease is caused by Echinococcus granulosus parasite. It is an endemic disease; in many Mediterranean countries. Bone involvement is reported in 1% - 2% of the cases and about 50% of those are seen in the spine [2]. The first hydatid disease in spine was reported in 1807 by Chaussier [3]. Spinal hydatid disease manifests itself through symptoms and signs related to compression of the cysts on other structures which has no specific pathognomonic symptoms or signs. The disease presents with radiculopathy, myelopathy and/or localized pain and tenderness owing to destructive bone lesions, pathological fracture and consequent cord compression [4]. MRI is a very sensitive diagnostic tool for hydatid cyst of spine [3].
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