Hydatid disease of the spine: a report on nine patients.

Purpose: The author presents this prospective study of nine cases of pathologically confirmed spinal hydatid disease.

Method: Hydatid disease is a difficult diagnosis in non endemic areas but it should be considered in the differential diagnosis of spinal pathology in endemic areas. Spinal involvement is very unusual. There is nothing typical of spinal involvement. Nine patients presented with hydatid disease of the spine between September 2001 and October 2010. The patients were clinically evaluated as well as by the latest imaging modalities, haematological and serological tests. All had decompressive surgery with or without fixation and the diagnosis was confirmed by histopathological examination. All received albendazole and praziquantel for ten months.

Results: MRI was the best diagnostic test, CAT scan was also useful, eosinophilia was a constant finding, and ESR was above normal in five patients. All had decompression laminectomy and clearance; in addition, transpedicular fixation was done to three patients. After surgery one patient had complete recovery with no recurrence, seven patients showed recurrence over time and residual disease was observed, and one patient died within 24 hours of surgery.

Conclusion: Diagnosis was easy from the start, but eradication was difficult, and recurrence rate was very high despite the use of chemotherapy.