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Vertebral hydatidosis and paraplegia.
S Karray1, M Zlitni, J V Fowles
1Institut National d'Orthopedie, Mohamed Kassab, Kassar Saïd, Tunisia.
The Journal of Bone and Joint Surgery. British Volume
|January 1, 1990
Summary
Vertebral hydatidosis often causes paraplegia, with poor prognosis. Circumferential decompression and grafting offer the best chance for remission in these complex spinal cord disease cases.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Spinal Surgery
Background:
- Vertebral hydatidosis is a rare parasitic infection causing significant spinal cord damage.
- Paraplegia secondary to vertebral hydatidosis presents complex management challenges.
Purpose of the Study:
- To report the management outcomes of paraplegia resulting from vertebral hydatidosis.
- To evaluate different surgical interventions for spinal hydatidosis.
Main Methods:
- Retrospective analysis of 13 patients (2 children, 11 adults) with paraplegia due to vertebral hydatidosis.
- Review of surgical procedures, including laminectomy, anterior decompression, and circumferential decompression with grafting.
- Assessment of patient outcomes, complications, and long-term remission rates.
Main Results:
- Vertebral body destruction and involvement of adjacent structures were common.
- High rates of relapse (100%) within two years for laminectomy or anterior decompression alone.
- Circumferential decompression and grafting yielded the best results, with 6/9 patients achieving remission.
Conclusions:
- Surgical management of vertebral hydatidosis causing paraplegia is associated with high morbidity and mortality.
- Circumferential decompression and grafting appear to be the most effective surgical strategy.
- Anthelminthic drugs may be adjunctive, but radical surgery remains crucial; remission, not cure, is the primary goal.