Advertisement

Infection

, Volume 25, Issue 4, pp 221–226 | Cite as

Hydatid disease of the spine: A survey study from Turkey

  • M. Turgut
Originalia

Summary

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.

Keywords

Turkey Postoperative Period Present Symptom Radiological Finding Operative Mortality 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Morris, D. L., Richards, K. S. Hydatid disease. Current medical and surgical management. Butterworth-Heinemann Ltd., Oxford 1992.Google Scholar
  2. 2.
    Pamir, N. N., Akalan, N., Özgen, T., Erbengi, A. Spinal hydatid cysts. Surg. Neurol. 21 (1991) 53–57.Google Scholar
  3. 3.
    Gökay, H. Vertebra kist hydatikleri (10 vak'a münasebebetsyle). Türk. Tıp. Cem. Mec. 34 (1968) 165–178.Google Scholar
  4. 4.
    Özer, A. F., Çataltepe, O., Taşkın, Y., Yalçınlar, Y., Akkaş, Ö., Şenel, K. Spinal kist hidatikler. Nöroloji Nöroşirürji Psikiyatri Dergisi 4 (1986) 184–186.Google Scholar
  5. 5.
    Özkal, E., Temel, F., Şenyüz, M., Ödev, K., Acar, O. Spinal kist hidatikler. Selçuk Üniv. Tıp Fak. Dergisi 26 (1987) 233–239.Google Scholar
  6. 6.
    Altınok, A., Tancar, F., Uçar, B., Dikilitaş, A., Keykubat, N. Spinal kist hidatikler. Türk Nöroşirürji Dergisi Ek 1 (1989) 58–61.Google Scholar
  7. 7.
    Tekkök, İ. H., Benli, K. Primary spinal extradural hydatid disease: report of a case with magnetic resonance characteristics and pathological correlation. Neurosurgery 33 (1993) 320–323.PubMedGoogle Scholar
  8. 8.
    Turgut, M., Benli, K., Eryılmaz, M.: Secondary multiple intracranial hydatid cysts caused by intracerebral embolism of cardiac echinococosis: an exceptional case of hydatidosis. J. Neurosurg. (1997) (in press).Google Scholar
  9. 9.
    Berkay, F. Echinococcose racidienne. J. Int. Coll. Surg. 22 (1954) 35–43.PubMedGoogle Scholar
  10. 10.
    Kılıç, C., Demirkazık, M., Boyar, B., Akalan, N., Erdem, H. Spinal kist hidatikler. Türk Nöroşirürji Dergisi Ek 1 (1989) 62–64.Google Scholar
  11. 11.
    Sarıbaş, Ş. Cases of hydatid cysts in the spine. Acta Med. Turcica 1 (1948) 51–58.Google Scholar
  12. 12.
    Önder, A., Aydın, İ. H., Ak, H. E., Takçı, E. Vertebral kist hidatikler. Atatürk Üniv. Tıp Fak. Bült. 22 (1990) 253–258.Google Scholar
  13. 13.
    Eren, N., Özgen, G. Simultaneous operation for right pulmonary and liver echinococcosis. Scand. J. Thor. Cardiovasc. Surg. 24 (1990) 131–134.Google Scholar
  14. 14.
    Rayport, M., Wisoff, H. S., Zaiman, H. Vertebral echinococcosis. J. Neurosurg. 21 (1964) 647–659.PubMedGoogle Scholar
  15. 15.
    İplikçioğlu, A. C., Kökeş, F., Bayar, A., Doğanay, Y. S., Buharalı, Z. Spinal invasion of pulmonary hydatidosis: computed tomographic demonstration. Neurosurgery 29 (1991) 467–468.PubMedGoogle Scholar
  16. 16.
    Özer, A. F., Özek, M. M., Pamir, M. N., Erzen, C. Magnetic resonance imaging in the diagnosis of spinal hydatid cyst disease. Case report. Paraplegia 31 (1993) 338–340.PubMedGoogle Scholar
  17. 17.
    Topaloğlu, A. Birisi ekstramedüller-subdural diğeri vertebral-paravertebral iki kist hidatik vakası. Türk. Tıp Cem. Mec. 24 (1958) 327–332.Google Scholar
  18. 18.
    Yeğen, C., Özer, A. F., Aktan, A. O., Yalım, R. Sacrococcygeal hydatic cyst: another entity in the differential diagnosis of sacrococcygeal chordoma. Case report. Paraplegia 31 (1993) 479–481.Google Scholar
  19. 19.
    Akhan, O., Dinler, A., Saatçi, I., Gülekon, N., Besim, A. Spinal intradural hydatic cysts in a child. Br. J. Radiol. 64 (1991) 464–466.Google Scholar
  20. 20.
    Bavbek, M., İnci, S., Tahta, K., Bertan, V. Primary multiple spinal extradural hydatid cysts of the literature: case report and review. Paraplegia 30 (1992) 517–519.PubMedGoogle Scholar
  21. 21.
    Charles, R. W., Govender, S., Naidoo, K. S. Echinococcal infection of the spine with neural involvement. Spine 13 (1988) 47–49.PubMedGoogle Scholar
  22. 22.
    Titiz, I., Oktay, S., Aktan, H. Internal medicine, symptomatology and treatment. Türk Tarih Kurumu Basımevi, Ankara 1962.Google Scholar
  23. 23.
    Braithwaite, P. A., Lees, R. F. Vertebral hydatid disease: radiological assessment. Radiology 140 (1981) 763–766.PubMedGoogle Scholar
  24. 24.
    Beşe, S. Medulla spinalis ve cerebrumda tümör arazı veren iki (kyste hydatique) vak'asi. Anadolu Kl. 11 (1944) 106–109.Google Scholar
  25. 25.
    Sarpyener, M. A. Pott hastalığını ve kısmen spondylite deformente'i taklit eden paravertebral adalelerin bir kyst hydatique'i. Türk. Tıp Cem. Mec. 15 (1949) 542–549.Google Scholar
  26. 26.
    Kılıçhan, E. Vertebra kist hidatiği. Türk. Tıp Cem. Mec. 6 (1958) 311–317.Google Scholar
  27. 27.
    Gökay, H. K., Bayülkem, F. Echinococcysticus'tan ileri gelen medulla basısı. Tıp Dünyası 32 (1959) 712–715.Google Scholar
  28. 28.
    Sanan, M. Son lokalizasyonunu medullada yapan bir hidatidosis vak'ası münasebetiyle. Ank. Nüm. Hast. Bült. 2 (1962) 245–252.Google Scholar
  29. 29.
    Rizeli, Y., Çeviker, N. Hidatik kiste bağlı iki kord basısı dolayısiyle. Ank. Num. Hast. Bült. 13 (1972) 220–226.Google Scholar
  30. 30.
    Kars, H. Z., Hekimoğlu, B., Cepoğlu, C. Spinal epidural hydatid cyst: radiological and ultrasonographic workup of a case. Eur. J. Radiol. 11 (1990) 212–214.PubMedGoogle Scholar
  31. 31.
    Hız, M., Akgün, I., Kasabalıgil, A., Okkan, S., Akçura, S., Dervişoğlu, S. The treatment of vertebral hydatid disease with albendazole and moderate dose local irradiation. Journal of Turkish Spinal Surgery 2 (1991) 19–20.Google Scholar
  32. 32.
    önal, Ç., Canbolat, A., Gökay, H., Kaya, U., Türker, K., Turantan, M. I., Barlas, O., İzgi, N., Ünal, F. Spinal hidatik kistler. Türk. Nöroşirürji Dergisi Ek 5 (1992) 34.Google Scholar
  33. 33.
    Öğüt, A. G., Kanberoğlu, K., Altu#x011F;, A., Çokyüksel, O. CT and MRJ in hydatid disease of cervical vertebrae. Neuroradiology 34 (1992) 430–432.PubMedGoogle Scholar
  34. 34.
    Göçer, İ., Tuna, M., İldan, F., Bağdatoğlu, H., Hacıyakupoğlu, S. Cervical intradural extramedullary hydatid cyst. Turkish Neurosurgery 4 (1994) 169–171.Google Scholar
  35. 35.
    Orhun, H., Kavaklı, B., Eren, H., Tecimer, T.: Hydatid disease in spine. 4th International Congress of Spine Surgery, İzmir, 26–30 May 1996, abstr. p. 166.Google Scholar
  36. 36.
    Marani, S. A. D., Canossi, G. C., Nicoli, F. A., Alberti, G. P., Monni, S. G., Casolo, P. M. Hydatid disease: MR imaging study. Radiology 175 (1990) 701–706.PubMedGoogle Scholar
  37. 37.
    Stern, W., Stern, W. E. Parasitic infestations. In:Wilkins, R. H., Rengachary, S. S. (eds.): Neurosurgery. McGraw-Hill, New York 1985, pp. 2010–2015.Google Scholar
  38. 38.
    Rowe, F. A., Youmans, J. R., Cabiesses, F. Parasitic and fungal disease of the central nervous system. In:Youmans, J. R. (ed.): Neurological surgery. W. B. Saunders, Philadelphia 1982, pp. 3366–3440.Google Scholar
  39. 39.
    Fiennes, A. G., Thomas, D. G. Combined medical and surgical treatment of spinal hydatid disease: a case report. J. Neurol. Neurosurg. Psychiatry 45 (1982) 927–931.PubMedGoogle Scholar
  40. 40.
    W. H. O. Guidelines for surveillance, prevention and control of echinococcosis/hydatidosis. World Health Organization, Geneva 1984.Google Scholar
  41. 41.
    Apt, W. L., Fierro, J. L., Calderon, C., Peraz, C., Mujica, P. Vertebral hydatid disease. Clinical experience with 27 cases. J. Neurosurg. 44 (1976) 72–76.PubMedGoogle Scholar
  42. 42.
    Ruelle, A., Boccardo, M., Lasio, G., Severi, P. Primary vertebral hydatidosis. Rev. Neurol. 55 (1985) 332–337.Google Scholar
  43. 43.
    Sharma, A., Kashyap, V., Abraham, J., Kurian, S. Intradural hydatic cysts. Surg. Neurol. 16 (1981) 235–237.Google Scholar
  44. 44.
    Ley, A., Marti, A. Intramedullary hydatic cyst. J. Neurosurg. 33 (1970) 257–259.Google Scholar
  45. 45.
    Porat, S., Robin, G. C., Wertheim, G. Hydatid disease of the spine causing paraplegia. The combined treatment by surgical drainage and mebendazole: a case report. Spine 9 (1984) 648–653.PubMedGoogle Scholar
  46. 46.
    Turtas, S., Viale, E. S., Pau, A. Long-term result of surgery for hydatid disease of the spine. Surg. Neurol. 13 (1980) 468–470.PubMedGoogle Scholar
  47. 47.
    Kaoutzanis, M., Anagnostopoulos, D., Apostolou, A. Hydatid disease affecting the vertebrae. Acta Neurochir. (Vienna) 98 (1989) 60–65.Google Scholar

Copyright information

© MMV Medizin Verlag GmbH München 1997

Authors and Affiliations

  • M. Turgut
    • 1
  1. 1.Dept. of NeurosurgeryAdnan Menderes University School of Medicine, Cumburiyet MahallesiAydinTurkey

Personalised recommendations