Treatment experiences of thoracic spinal hydatidosis: a single-center case-series study

Abstract

Spinal hydatid disease is rare and remains a serious health problem associated with high rates of recurrence. We report our experience in treating patients with thoracic spinal hydatidosis through a single-center case-series study. Methods: Sixteen patients with thoracic spinal hydatidosis were treated in our center between 1995 and 2017. A total en bloc spondylectomy (TES) was performed in three patients. Five patients were treated with posterior decompression and stabilization after removing the involved elements. The remaining patients underwent curettage and resection of the infected bone. The therapy was completed with medical treatment or radiotherapy. Results: Of the 16 patients, seven were men and nine were women; their mean age was 38.5 years (range 28-60 years). The infected area was the upper thoracic level in one patient, mid thoracic level in eight patients, and lower thoracic level in seven patients. Four patients had paraplegia and seven had paraparesis before surgery. At the last follow-up, five patients had successfully recovered from the neurological damage. During a mean follow-up of 4.75 years (range 2-12 years), eight patients had local recurrence; however, no patient who underwent TES had recurrence. Conclusions: An individualized surgical strategy should be decided carefully for each patient in the first intervention. In the early stages of the disease, TES should be considered as a treatment for suitable cases of primary thoracic spinal hydatidosis.

Multiple debridement of cavity lesions combined with antiparasitic chemotherapy in the treatment of mid or advanced spinal echinococcosis: a retrospective study of 33 patients

“…Via published literatures (Hamdan, 2012;Kafaji et al, 2013;Liang et al, 2019;Neumayr et al, 2013b;Prabhakar et al, 2005), the good clinical efficacy of the utilization of titanium cage or cage fusion in the reconstruction of spinal structure has been confirmed. Besides, the use of polymethylmethacrylate (PMMA) bone cement in the treatment of bone defects has been concerned widely (Banerjee et al, 2012;Kalinova et al, 2005;Yildiz et al, 2001).…”

“…Twenty-six patients experienced regional recurrence after one year (89%) and 10 (27.8%) patients were disease-free after a mean of 5.3 follow-up years. Furthermore, a published case series of sixteen patients with thoracic spinal echinococcosis by Liang et al (Liang et al, 2019), 3 patients were conducted by total en bloc spondylectomy (TES), 5 patients were treated posterior decompression and stabilization after removing the involved elements, and the rest patients underwent radical debridement surgery. Eight patients had local recurrence, but no patients who underwent TES had recurrence in the mean follow-up of 4.75 years (range 2-12 years).…”

“…Plenty of patients are not hospitalized until symptoms of spinal cord compression, which is illustrated in the late stages of the disease, since the occult at early stage (Gottstein et al, 2015;Grosso et al, 2012;Safari et al, 2021;Sioutis et al, b;Song et al, 2007;Xie et al, 2015). Surgery, either curettage or resection, is considered as the treatment of choice, and needed urgently in this setting (Liang et al, 2019;Sioutis et al, 2021b;Song et al, 2007). The purpose of surgery is to decompress the spinal cord adequately and stabilize the damaged spinal cord, and remove the hydatid cyst completely without rupturing it (Gezercan et al, 2017b;Hamdan, 2012;Pamir et al, 2002;Sapkas et al, 2006;Sioutis et al, 2021b;Song et al, 2007).…”

Incurable and refractory spinal cystic echinococcosis: A case report

“…Therefore, even if only a part of the vertebral body is involved, some authors still recommend total vertebrectomy to prevent recurrence. Liang et al [ 18 ] reported that there was no recurrence after total en bloc spondylectomy of spinal hydatidosis, and the patients were free of disease[ 19 ]. This suggests that expanded total en bloc spondylectomy may be a better choice for this patient.…”

In Vitro and In Vivo Efficacy of Albendazole Chitosan Microspheres with Intensity-Modulated Radiation Therapy in the Treatment of Spinal Echinococcosis

“…However, operation on lesions next to the nerve tissue still has significant risks. Some patients may experience severe anaphylactic shock or death due to the release of fluid in the cyst after surgery, which also leads to a high recrudescence rate of 25% ( 9 ). Chemotherapy with benzimidazole carbamates, such as albendazole (ABZ) and mebendazole (MBZ), is a conservative option in inoperable cases of spinal CE.…”