Vertebral hydatid disease: radiological assessment.

Braithwaite, Peter; Lees, R F

doi:10.1148/radiology.140.3.7280247

Cited by 186 publications

(122 citation statements)

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“…The intraspinal cyst formation was located between the stretched dural sac and the vertebral bodies of the kyphotic apex causing significant compression of the cord (Figs. 2,3,4). A progressive neurologic deficit was reported by the patient.…”

mentioning

confidence: 87%

“…If the worm is not lodged in liver or lungs, it may be trapped virtually anywhere in the body, such as peritoneum, spleen, kidney, heart, brain, spine, bony skeleton and muscles. Not every larva develops, over 90% are eliminated by the host reaction [4,5,19].…”

Section: Epidemiology Pathologymentioning

confidence: 99%

“…Radiologically, the spinal manifestations can be classified into five different types according to Braithwaite and Lees [4,18,19]. The primary cyst can be located intramedullary, intradural-extramedullary, extradural, hydatid cyst of the vertebrae, and paravertebral lesions extending to spinal structures.…”

Section: Diagnosis Differential Diagnosismentioning

confidence: 99%

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Severe kyphoscoliosis after primary Echinococcus granulosus infection of the spine

Thaler

Gabl²,

Lechner

et al. 2010

Eur Spine J

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A primary Echinococcus granulosus infection of the spine involving the vertebrae T8 and T9 of a 6-year-old child was treated elsewhere by thoracotomy, partial corporectomy, multiple laminectomies and uninstrumented fusion. Owing to inappropriate stabilization, severe deformity developed secondary to these surgeries. X-rays, CT and MRI scans of the spine revealed a severe thoracic kyphoscoliosis of more than 100° (Fig. 1) and recurrence of Echinococcus granulosus infection. The intraspinal cyst formation was located between the stretched dural sac and the vertebral bodies of the kyphotic apex causing significant compression of the cord (Figs. 2,3,4). A progressive neurologic deficit was reported by the patient. At the time of referral, the patient was wheelchair bound and unable to walk by herself (Frankel Grade C). Standard antiinfectious therapy of Echinococcus granulosus requires a minimum treatment period of 3 months. This should be done before any surgical intervention because in case of a rupture of an active cyst, the delivered lipoprotein antigens of the parasite may cause a potentially lethal anaphylactic shock. Owing to the critical neurological status, we decided to perform surgery without full length preoperative antiinfectious therapy. Surgical treatment consisted in posterior vertebral column resection technique with an extensive bilateral costotransversectomy over three levels, re-decompression with cyst excision around the apex and multilevel corporectomy of the apex of the deformity. Stabilisation and correction of the spinal deformity were done by insertion of a vertebral body replacement cage anteriorly and posterior shortening by compression and by a multisegmental pedicle screw construct. After the surgery, antihelminthic therapy was continued. The patients neurological deficits resolved quickly: 4 weeks after surgery, the patient had Frankel Grade D and was ambulatory without any assistance. After an 18-month follow-up, the patient is free of recurrence of infection and free of neurologically deficits (Frankel E). This case demonstrates that inappropriate treatment-partial resection of the cyst, inappropriate anterior stabilization and posterior multilevel laminectomies without posterior stabilization-may lead to severe progressive kyphoscoliotic deformity and recurrence of infection, both leading to significant neurological injury presenting as a very difficult to treat pathology.

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confidence: 87%

Section: Epidemiology Pathologymentioning

confidence: 99%

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Severe kyphoscoliosis after primary Echinococcus granulosus infection of the spine

Thaler

Gabl²,

Lechner

et al. 2010

Eur Spine J

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show abstract

“…Vertebral hydatid cyst infection has been classified according to the anatomical location of the hydatid infection into five subgroups: (1) intramedullary hydatid cyst; (2) intraduralextramedullary hydatid cyst; (3) extradural intraspinal hydatid cyst; (4) vertebral hydatid cyst; and (5) paravertebral hydatid cyst [5]. However, as the authors mentioned, there is no pathognomonic clinical picture of the disease [1].…”

Section: Locationmentioning

confidence: 99%

“…Vertebral hydatid cyst infection has typically an invasive nature, and the removal of all the cysts cannot be achieved without perforating the cyst wall in the majority of cases [3,5,9,12]. Recently, successful treatment of hydatid disease with albendazole (ALB) for at least 1 year has been reported [3,6,7].…”

Section: Value Of Albendazolementioning

confidence: 99%