Summary
Spinal hydatid disease is rare, even in rural areas where echinococcosis is endemic. Although the liver and lungs are commonly involved, spinal hydatid disease, either primary or secondary, represents an uncommon but significant manifestation of the disease. This survey study reviews 28 reports of spinal hydatid disease from Turkey during the past 5 decades. Only 14 patients also had pulmonary or some other organ infestation. The cysts affecting the spine were commonly in the thoracic region. Most patients had intraspinal extradural hydatid cysts associated with vertebral involvement. The presenting symptoms were mostly atypical, and it was interesting that most of the patients were misdiagnosed preoperatively as Pott's disease during the first decades, suggesting that new imaging techniques such as CT and MRI are the diagnostic procedures of choice for this disease. Surgery remains the best therapy for spinal hydatid disease, although adjuvant antihelminthic therapy may be necessary. There were only 15 cases of recurrence (18%); surgical intervention was palliative in all these patients and it was followed by chemotherapy. Operative mortality was very low (two patients died in the early postoperative period) and there were no complications related to treatment with antihelminthic drugs. The study indicates that hydatid disease should be considered in the differential diagnosis when radiological findings suggest spinal infections or tumors, and that surgical decompression in association with chemotherapy is the treatment of choice.
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Morris, D. L., Richards, K. S. Hydatid disease. Current medical and surgical management. Butterworth-Heinemann Ltd., Oxford 1992.
Pamir, N. N., Akalan, N., Özgen, T., Erbengi, A. Spinal hydatid cysts. Surg. Neurol. 21 (1991) 53–57.
Gökay, H. Vertebra kist hydatikleri (10 vak'a münasebebetsyle). Türk. Tıp. Cem. Mec. 34 (1968) 165–178.
Özer, A. F., Çataltepe, O., Taşkın, Y., Yalçınlar, Y., Akkaş, Ö., Şenel, K. Spinal kist hidatikler. Nöroloji Nöroşirürji Psikiyatri Dergisi 4 (1986) 184–186.
Özkal, E., Temel, F., Şenyüz, M., Ödev, K., Acar, O. Spinal kist hidatikler. Selçuk Üniv. Tıp Fak. Dergisi 26 (1987) 233–239.
Altınok, A., Tancar, F., Uçar, B., Dikilitaş, A., Keykubat, N. Spinal kist hidatikler. Türk Nöroşirürji Dergisi Ek 1 (1989) 58–61.
Tekkök, İ. H., Benli, K. Primary spinal extradural hydatid disease: report of a case with magnetic resonance characteristics and pathological correlation. Neurosurgery 33 (1993) 320–323.
Turgut, M., Benli, K., Eryılmaz, M.: Secondary multiple intracranial hydatid cysts caused by intracerebral embolism of cardiac echinococosis: an exceptional case of hydatidosis. J. Neurosurg. (1997) (in press).
Berkay, F. Echinococcose racidienne. J. Int. Coll. Surg. 22 (1954) 35–43.
Kılıç, C., Demirkazık, M., Boyar, B., Akalan, N., Erdem, H. Spinal kist hidatikler. Türk Nöroşirürji Dergisi Ek 1 (1989) 62–64.
Sarıbaş, Ş. Cases of hydatid cysts in the spine. Acta Med. Turcica 1 (1948) 51–58.
Önder, A., Aydın, İ. H., Ak, H. E., Takçı, E. Vertebral kist hidatikler. Atatürk Üniv. Tıp Fak. Bült. 22 (1990) 253–258.
Eren, N., Özgen, G. Simultaneous operation for right pulmonary and liver echinococcosis. Scand. J. Thor. Cardiovasc. Surg. 24 (1990) 131–134.
Rayport, M., Wisoff, H. S., Zaiman, H. Vertebral echinococcosis. J. Neurosurg. 21 (1964) 647–659.
İplikçioğlu, A. C., Kökeş, F., Bayar, A., Doğanay, Y. S., Buharalı, Z. Spinal invasion of pulmonary hydatidosis: computed tomographic demonstration. Neurosurgery 29 (1991) 467–468.
Özer, A. F., Özek, M. M., Pamir, M. N., Erzen, C. Magnetic resonance imaging in the diagnosis of spinal hydatid cyst disease. Case report. Paraplegia 31 (1993) 338–340.
Topaloğlu, A. Birisi ekstramedüller-subdural diğeri vertebral-paravertebral iki kist hidatik vakası. Türk. Tıp Cem. Mec. 24 (1958) 327–332.
Yeğen, C., Özer, A. F., Aktan, A. O., Yalım, R. Sacrococcygeal hydatic cyst: another entity in the differential diagnosis of sacrococcygeal chordoma. Case report. Paraplegia 31 (1993) 479–481.
Akhan, O., Dinler, A., Saatçi, I., Gülekon, N., Besim, A. Spinal intradural hydatic cysts in a child. Br. J. Radiol. 64 (1991) 464–466.
Bavbek, M., İnci, S., Tahta, K., Bertan, V. Primary multiple spinal extradural hydatid cysts of the literature: case report and review. Paraplegia 30 (1992) 517–519.
Charles, R. W., Govender, S., Naidoo, K. S. Echinococcal infection of the spine with neural involvement. Spine 13 (1988) 47–49.
Titiz, I., Oktay, S., Aktan, H. Internal medicine, symptomatology and treatment. Türk Tarih Kurumu Basımevi, Ankara 1962.
Braithwaite, P. A., Lees, R. F. Vertebral hydatid disease: radiological assessment. Radiology 140 (1981) 763–766.
Beşe, S. Medulla spinalis ve cerebrumda tümör arazı veren iki (kyste hydatique) vak'asi. Anadolu Kl. 11 (1944) 106–109.
Sarpyener, M. A. Pott hastalığını ve kısmen spondylite deformente'i taklit eden paravertebral adalelerin bir kyst hydatique'i. Türk. Tıp Cem. Mec. 15 (1949) 542–549.
Kılıçhan, E. Vertebra kist hidatiği. Türk. Tıp Cem. Mec. 6 (1958) 311–317.
Gökay, H. K., Bayülkem, F. Echinococcysticus'tan ileri gelen medulla basısı. Tıp Dünyası 32 (1959) 712–715.
Sanan, M. Son lokalizasyonunu medullada yapan bir hidatidosis vak'ası münasebetiyle. Ank. Nüm. Hast. Bült. 2 (1962) 245–252.
Rizeli, Y., Çeviker, N. Hidatik kiste bağlı iki kord basısı dolayısiyle. Ank. Num. Hast. Bült. 13 (1972) 220–226.
Kars, H. Z., Hekimoğlu, B., Cepoğlu, C. Spinal epidural hydatid cyst: radiological and ultrasonographic workup of a case. Eur. J. Radiol. 11 (1990) 212–214.
Hız, M., Akgün, I., Kasabalıgil, A., Okkan, S., Akçura, S., Dervişoğlu, S. The treatment of vertebral hydatid disease with albendazole and moderate dose local irradiation. Journal of Turkish Spinal Surgery 2 (1991) 19–20.
önal, Ç., Canbolat, A., Gökay, H., Kaya, U., Türker, K., Turantan, M. I., Barlas, O., İzgi, N., Ünal, F. Spinal hidatik kistler. Türk. Nöroşirürji Dergisi Ek 5 (1992) 34.
Öğüt, A. G., Kanberoğlu, K., Altu#x011F;, A., Çokyüksel, O. CT and MRJ in hydatid disease of cervical vertebrae. Neuroradiology 34 (1992) 430–432.
Göçer, İ., Tuna, M., İldan, F., Bağdatoğlu, H., Hacıyakupoğlu, S. Cervical intradural extramedullary hydatid cyst. Turkish Neurosurgery 4 (1994) 169–171.
Orhun, H., Kavaklı, B., Eren, H., Tecimer, T.: Hydatid disease in spine. 4th International Congress of Spine Surgery, İzmir, 26–30 May 1996, abstr. p. 166.
Marani, S. A. D., Canossi, G. C., Nicoli, F. A., Alberti, G. P., Monni, S. G., Casolo, P. M. Hydatid disease: MR imaging study. Radiology 175 (1990) 701–706.
Stern, W., Stern, W. E. Parasitic infestations. In:Wilkins, R. H., Rengachary, S. S. (eds.): Neurosurgery. McGraw-Hill, New York 1985, pp. 2010–2015.
Rowe, F. A., Youmans, J. R., Cabiesses, F. Parasitic and fungal disease of the central nervous system. In:Youmans, J. R. (ed.): Neurological surgery. W. B. Saunders, Philadelphia 1982, pp. 3366–3440.
Fiennes, A. G., Thomas, D. G. Combined medical and surgical treatment of spinal hydatid disease: a case report. J. Neurol. Neurosurg. Psychiatry 45 (1982) 927–931.
W. H. O. Guidelines for surveillance, prevention and control of echinococcosis/hydatidosis. World Health Organization, Geneva 1984.
Apt, W. L., Fierro, J. L., Calderon, C., Peraz, C., Mujica, P. Vertebral hydatid disease. Clinical experience with 27 cases. J. Neurosurg. 44 (1976) 72–76.
Ruelle, A., Boccardo, M., Lasio, G., Severi, P. Primary vertebral hydatidosis. Rev. Neurol. 55 (1985) 332–337.
Sharma, A., Kashyap, V., Abraham, J., Kurian, S. Intradural hydatic cysts. Surg. Neurol. 16 (1981) 235–237.
Ley, A., Marti, A. Intramedullary hydatic cyst. J. Neurosurg. 33 (1970) 257–259.
Porat, S., Robin, G. C., Wertheim, G. Hydatid disease of the spine causing paraplegia. The combined treatment by surgical drainage and mebendazole: a case report. Spine 9 (1984) 648–653.
Turtas, S., Viale, E. S., Pau, A. Long-term result of surgery for hydatid disease of the spine. Surg. Neurol. 13 (1980) 468–470.
Kaoutzanis, M., Anagnostopoulos, D., Apostolou, A. Hydatid disease affecting the vertebrae. Acta Neurochir. (Vienna) 98 (1989) 60–65.
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Turgut, M. Hydatid disease of the spine: A survey study from Turkey. Infection 25, 221–226 (1997). https://doi.org/10.1007/BF01713148
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DOI: https://doi.org/10.1007/BF01713148