Vertebral hydatidosis and paraplegia

Abstract

We report the management of two children and 1 1 adults with paraplegia secondary to vertebral hydatidosis. Destruction of pedicles, posterior vertebral elements and discs as well as the vertebral bodies was common and all six patients with thoracic disease had involvement of adjacent ribs. The 13 patients had a total of 42 major surgical procedures; two patients died from postoperative complications and four from complications of the disease and paraplegia. All eight patients initially freated by laminectomy or anterior decompression alone relapsed within two years and seven required further surgery. Circumferential decompression and grafting gave the best results, six of nine patients being in remission an average of three years and six months later. The prognosis for such patients is poor; remission is the aim, rather than cure. Anthelminthic drugs may improve the prognosis, but radical surgery is likely to remain the keystone of treatment in the foreseeable future. The incidence of human infestation with Echinococcus granulosus is increasing, and the parasite is appearing in areas of the world previously free of it (Williams, Lopez, Adaros and Trejos 1971 ; Matossian, Rickard and Smyth 1977). We report the treatment and results of 13 patients with paraplegia due to vertebral hydatidosis.

Intradural extramedullary spinal hydatidosis: case report

“…Unfortunately, the results of surgical treatment are not gratifying, as apparent radical removal is usually followed by recurrence or progression of the illness, as occurred in our patient. Intradural disease is also associated with intense arachnoiditis, which difficults surgical resection of the cysts and increases the risk of neurological deterioration as well as of spreading of the disease through the subarachnoid space, a fact that might have occurred in our patient 11,15 . To prevent recurrence or spreading of the disease, irrigation with hypertonic saline or a diluted Betadine solution after removal of the cysts has been proposed; other authors have used 10% formalin solution to irrigate the surgical field, but the dura should not be opened [18][19][20][21] .…”

Vertebral hydatid cyst infection (Echinococcus granulosus): a case report

“…The basic manner of progression of bone echinococcosis in the vertebral column is similar to that in other bones, i.e. chronicity without systemic disturbances, but ultimately the disease becomes clinically manifest [8]. Pain, deformity, and weakness may result from either collapse of the spine or by extension of the process beyond skeletal confines.…”

Spinal Hydatid Cyst: Review

“…The ra te of so me symptoms are as fol lows: back pain 85%, ra di cu lar pa in 25-95% and pa ra pa re sis 25-77%. 4,17 Anot her study stres sed out that the most com mon signs we re pa ra pa re sis (62%) or pa rap legi a (26%), low back pa in or ra di cu lar pa in (55%), sen sa ti on di sor ders (36%), and sphinc ter de fi cits (30%). 5 In a me ta-analy sis per for med in our co untry, the ra tes of com mon signs we re as fol lows: weak ness in lo wer ex tre mi ti es 73%, low back pa in 43%, blad der/in tes ti ne dysfunc ti on 32%, pa in in lower ex tre mi ti es 27%, sen sa ti on di sor ders 24%, and pa ra ver teb ral swel ling 2%.…”

“…In vol ve ment of the cervi cal re gi on is re por ted to be the le ast common. 4,8,9,12,14,15,17 Spi nal in vol ve ment was clas si fi ed by Bra ithwa i te and Le es in to 5 types: 1. Pri mary in tra me dullary, 2.…”

“…1,3,[26][27][28] Com pres si on and cor ti cal we ake ning se con dary to os te o nec ro sis le ad to pat ho lo gi cal frac tu res and spre ading to the pe dic le, la mi na, and cos ta e can ta ke pla ce. 4,5,17,20 As the cyst de ve lopment was li mi ted with the pe ri os te um, in ter ver tabral disc spa ces are ge ne rally pre ser ved. 4,5,20 The ra te of cyst de ve lop ment is 7 mm/month.…”