The use of polymethylmethacrylate in the management of hydatid disease of bone

Abstract

Hydatid disease of bone is rare. It probably represents between 0.5% and 4% of all human hydatid disease and, in about 60% of patients, affects the spine or pelvis. Between 1986 and 1998, we treated 15 cases of bone hydatidosis. Curettage, swabbing with povidone iodine and filling the defect with polymethylmethacrylate (PMMA) were carried out in ten patients. Three of these had a recurrence after five years, but seven had no signs of relapse during a mean follow-up of 52 months. We believe that the combination of antihelminthic therapy, wide resection and the use of PMMA gives the best outcome in the treatment of bone hydatidosis.

Cystic Echinococcosis of the Bone: A European Multicenter Study

“…Some authors are even skeptical about the actual role of medical treatment, 4,11,12,25,26 supporting the opinion that only radical surgery is able to cure the disease. 13,26 In our cohort, all patients received prolonged courses of ABZ, which was not only longer than the current standard recognized by regulatory agencies (a maximum of three cycles each of 28 days, with a pause of 14 days separating each cycle), but also longer than what is usually done for CE in other organs, where continuous administration of ABZ for 3 to 6 months is generally used. 27 Overall, prolonged administration was well tolerated and no patient had to stop the administration of ABZ.…”

Spinal Cystic Echinococcosis – A Systematic Analysis and Review of the Literature: Part 2. Treatment, Follow-up and Outcome

“…The location and the extent of the lesion(s) determine the surgical approach and the necessary surgical procedure (table 2). After resection of affected bone, a wide spectrum of techniques has been employed to stabilize the vertebral column (including bone grafts [17], [25]–[43], dorsal stabilisation by pedicle screw systems [9], [26], [27], [37], [44]–[48], Harrington- [9], [27], [36], [39], [49]–[51] and Luque- [9], [45], [50], [51] rods, vertebral body replacement by titanium cage implantation [44], [52], [53], plating [25], [35], [52], [54], bone cement [26], [55], [56]). However, in the absence of evidence no recommendations regarding the use of a specific technique can be given besides possibly bone grafting.…”

“…However, in the absence of evidence no recommendations regarding the use of a specific technique can be given besides possibly bone grafting. Considering that osseous grafts might be invaded by persisting or recurrent disease, the use of acrylic cement for osteosynthesis has been discussed [27], and in a case series of 10 patients with bone CE (including 2 cases with spinal CE) Yildiz and colleagues reported that the use of polymethylmethacrylate (PMMA) cement lowered recurrence rate and prolonged the interval between recurrences [55]. Regarding the surgical approach, two rare cases of spinal CE affecting the craniocervical junction might be worth mentioning for their surgical approach via an enoral route [33], [43].…”

“…A major limitation of the available data on recurrence of spinal CE is the overall short follow-up period throughout the literature (table 2) and only a few case series shed light on the long-term prospects [3], [9], [24], [38], [55], [57]. To obtain solid data on the long-term outcome of the various forms of spinal CE, larger numbers of cases and follow-up over many years, possibly even decades, would be required.…”

Hydatid Cyst of the Knee: A Case Report

“…According to the high blood flow of the right lobe of the liver, most of the cysts are formed in this site [8]. Rupture of the cyst is one of the most important complications of musculoskeletal hydatidosis that results in release of daughter cysts and extension of the disease sometimes leading to anaphylactic shock [9]. …”