Spinal cord compression secondary to vertebral echinococcosis

Area of Science:

• Neurosurgery
• Infectious Diseases
• Radiology

Background:

• Spinal trauma can lead to vertebral collapse and neurological deficits.
• Tuberculous spondylitis is a common cause of vertebral lesions, especially in endemic areas.
• Differentiating spinal infections and other pathologies can be challenging based on initial imaging and clinical presentation.

Observation:

• A patient presented with progressive lower limb weakness and paresthesia following a fall.
• Imaging revealed collapsed thoracic vertebrae (Th2-Th3), initially suspected as tuberculous spondylitis.
• Despite anti-tuberculosis treatment, the patient showed no clinical improvement.

Findings:

• Surgical intervention, including discectomy, corpectomy, and iliac bone grafting, was performed.
• Histopathological analysis of the biopsy specimen identified a vertebral hydatid cyst as the underlying cause.
• The patient developed and subsequently recovered from an esophagocutaneous fistula post-surgery.

Implications:

• This case highlights the importance of considering rare etiologies like hydatid cysts in spinal lesions, even when tuberculous spondylitis is suspected.
• Accurate diagnosis through biopsy is crucial for effective treatment, leading to favorable outcomes.
• Surgical decompression and appropriate medical management (albendazole) can result in significant neurological recovery in patients with vertebral hydatid cysts.