Hydatid disease of the spine: a survey study from Turkey

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.