Recurrent spinal hydatidosis causing Gibbus deformity: Report of a rare case

Hydatid disease is caused by the larvae of the parasite Echinococcus granulosus and, less commonly, Echinococcus multilocularis in the endemic regions. A hydatid cyst of Echinococcus granulosus commonly develops in the liver and lungs of the affected individual and rarely occurs in the brain, bones, and heart. The spinal hydatidosis comprises 50% of the cases affecting the bones, which usually leads to severe morbidities. We present a case of a 52-year-old Afghan woman presented to the hospital with Gibbus deformity, complaining of lower back pain and flaccid paraplegia for one year. Findings of Magnetic Resonance Imaging of the lumbosacral spine were suggestive of a hydatid cyst involving the vertebrae with extension to the paravertebral soft tissue, leading to acute kyphosis, severe canal stenosis, and cord compression. Treatment included complete cyst removal. The diagnosis was confirmed by gross and microscopic evaluation of the cyst contents. The patient was discharged after significant pain relief and deformity correction. Vertebral hydatidosis is notorious for its recurrence despite vigorous surgical and medical treatment. The hydatid cyst grows rapidly and can cause irreversible damage to the spinal cord in neglected cases. Currently, the best treatment approach is complete surgical removal of the cyst, irrigation with a scolicidal agent, and postoperative follow-up with a long-term course of albendazole. Spinal hydatidosis is a rare, severe disease with significant morbidity. Despite significant scientific advances in understanding of disease pathogenesis, the parasite's predilection for the spine and the influence of host-specific factors on anatomical manifestations remain a mystery.