Vertebral Hydatidosis

Abstract

Hydatid disease is prevalent in the sheep-raising areas. Bone hydatidosis is rare and occurs in 1% to 4% of all cases of human hydatidosis. About 50% of cases of bone hydatidosis are spinal. In a retrospective study, 9 patients with hydatid disease of spine who had treated surgically were evaluated. There were 5 men and 4 women, with mean age of 31 years and a range of 19 to 50 years. Diagnosis was made by means of myelography, computerized tomography, and magnetic resonance imaging. The main surgical intervention was laminectomy in all cases. In a case of recurrent disease, vertebrectomy and anterolateral spinal fusion and instrumentation was performed through an anterior transabdominal approach. Surgical field was irrigated by 0.5% silver nitrate and 10% hypertonic saline. Albendazole was given as an adjuvant therapy in the cases of bony involvement. Location of the disease was thoracic in 6 cases, cervical in 2 cases, and lumbar in 1 case. Outcome was excellent in 3 cases, improvement in 1 case, no recovery in 1 case, and recurrence in 3 cases. Spinal hydatidosis is a locally malignant disease with high recurrence rate. Eradication of the disease cannot be achieved even after radical surgery and chemotherapy. Although role of the chemotherapy in the prevention of the disease is not specifically determined, it is recommended in almost all reports. The preferred management is the spinal decompression, vertebrectomy, and instrumentation in appropriate cases and postoperative Albendazole therapy as a chemotherapic drug of choice. The best and ideal treatment is the prevention of the disease by eradication of parasites from the hosts in the endemic areas.