Outcome and Follow-up of Patients with Spinal Hydatidosis

  • Lukas K. Postl
  • Chlodwig Kirchhoff


Detailed information about the two types of echinococcosis, the cystic echinococcosis and the alveolar echinococcosis, is provided separately in specific sections. The outcome of hydatid disease will significantly depend on the location of the lesions. According to our opinion, every patient suffering from hydatid disease needs a clearly structured aftercare and follow-up calendar including physical examination, imaging, as well as serologic tests. This follow-up should also be individualized and consider the surgical progress, i.e., in case surgical spreading of the echinococcosis is likely, the follow-up needs to be adapted. Surgical decompression and chemotherapy are the principal forms of treatment in pediatric and adolescent cases of spinal hydatidosis. Unfortunately even with extensive surgery, results are far from being curative.


Hydatid Cyst Surgical Decompression Contrast Material Administration Anthelmintic Treatment Cystic Echinococcosis 
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.


  1. Ammann RW, Eckert J. Cestodes. Echinococcus. Gastroenterol Clin North Am. 1996;25:655–89.PubMedCrossRefGoogle Scholar
  2. Arif SH, Zaheer S. Intradural extramedullary primary hydatid cyst of the spine in a child: a very rare presentation. Eur Spine J. 2009;18:179–82.PubMedCrossRefPubMedCentralGoogle Scholar
  3. Baysefer A, Gonul E, Canakci Z, Erdogan E, Aydogan N, Kayali H. Hydatid disease of the spine. Spinal Cord. 1996;34:297–300.PubMedCrossRefGoogle Scholar
  4. Belhassen-Garcia M, Carpio-Perez A, Blanco JF, Velasco-Tirado V, Pardo-Lledias J. Recurrent spinal echinococcosis. Int J Infect Dis. 2011;15:e435–6.PubMedCrossRefGoogle Scholar
  5. Bettaieb A, Khaldi M, Ben Rhouma T, Touibi S. Spinal echinococcosis; clinical study of 32 cases (in French). Neurochirurgie. 1978;24:205–10.PubMedGoogle Scholar
  6. Braithwaite PA, Lees RF. Vertebral hydatid disease: radiological assessment. Radiology. 1981;140:763–6.PubMedGoogle Scholar
  7. Bron JL, van Kemenade FJ, Verhoof OJ, Wuisman PI. Long term follow-up of a patient with disseminated spinal hydatidosis. Acta Orthop Belg. 2007;73:678–82.PubMedGoogle Scholar
  8. Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010;114:1–16.PubMedCrossRefGoogle Scholar
  9. Celik C, Sasmaz MF, Oktay F, Ucan H, Kaptanoglu E. Paraplegia associated with spinal hydatid cyst: a case report. Spine (Phila Pa 1976). 2010;35:E356–8.CrossRefGoogle Scholar
  10. Claudon M, Bracard S, Plenat F, Regent D, Bernadac P, Picard L. Spinal involvement in alveolar echinococcosis: assessment of two cases. Radiology. 1987;162:571–2.PubMedGoogle Scholar
  11. Duewell S, Marincek B, von Schulthess GK, Ammann R. MRT and CT in alveolar echinococcosis of the liver (in German). Rofo. 1990;152:441–5.PubMedCrossRefGoogle Scholar
  12. Haddad FS, Haddad FS, Haddad SI. La malignité de l’échinococcose. Rev Med Moyen Orient. 1963;20:270–5.PubMedGoogle Scholar
  13. Herrera A, Martinez AA, Rodriguez J. Spinal hydatidosis. Spine (Phila Pa 1976). 2005;30:2439–44.CrossRefGoogle Scholar
  14. Islekel S, Ersahin Y, Zileli M, Oktar N, Oner K, Ovül I, Ozdamar N, Tuncbay E. Spinal hydatid disease. Spinal Cord. 1998;36:166–70.PubMedCrossRefGoogle Scholar
  15. Keller TM, Schweitzer JS, Helfend LK, Chappell T. Treatment of progressive cervical spinal instability secondary to hydatid disease. A case report. Spine (Phila Pa 1976). 1997;22:915–9.CrossRefGoogle Scholar
  16. Kotil K, Tari R, Savas Y. Medical treatment of primary extradural solitary lumbar hydatid disease. J Clin Neurosci. 2010;17:793–5.PubMedCrossRefGoogle Scholar
  17. Lawn SD, Bligh J, Craig PS, Chiodini PL. Human cystic echinococcosis: evaluation of post-treatment serologic follow-up by IgG subclass antibody detection. Am J Trop Med Hyg. 2004;70:329–35.PubMedGoogle Scholar
  18. Limaiem F, Bellil S, Bellil K, Chelly I, Mekni A, Khaldi M, Haouet S, Zitouna M, Kchir N. Primary hydatidosis of the central nervous system: a retrospective study of 39 Tunisian cases. Clin Neurol Neurosurg. 2010;112:23–8.PubMedCrossRefGoogle Scholar
  19. Merkle EM, Kramme E, Vogel J, Krämer S, Schulte M, Usadel S, Kern P, Brambs HJ. Bone and soft tissue manifestations of alveolar echinococcosis. Skeletal Radiol. 1997;26:289–92.PubMedCrossRefGoogle Scholar
  20. Nell M, Burgkart RH, Gradl G, von Eisenhart-Rothe R, Schaeffeler C, Trappe D, da Costa CP, Gradinger R, Kirchhoff C. Primary extrahepatic alveolar echinococcosis of the lumbar spine and the psoas muscle. Ann Clin Microbiol Antimicrob. 2011;10:13.PubMedCrossRefPubMedCentralGoogle Scholar
  21. Nouir NB, Nuñez S, Frei E, Gorcii M, Müller N, Gianinazzi C, Mekki M, Nouri A, Babba H, Gottstein B. Post-surgical follow-up (by ELISA and immunoblotting) of cured versus non-cured cystic echinococcosis in young patients. Parasitology. 2008;135:105–14.PubMedCrossRefGoogle Scholar
  22. Ozek MM. Complications of central nervous system hydatid disease. Pediatr Neurosurg. 1994;20:84–91.PubMedCrossRefGoogle Scholar
  23. Pamir MN, Akalan N, Ozgen T, Erbengi A. Spinal hydatid cysts. Surg Neurol. 1984;21:53–7.PubMedCrossRefGoogle Scholar
  24. Pamir MN, Ozduman K, Elmaci I. Spinal hydatid disease. Spinal Cord. 2002;40:153–60.PubMedCrossRefGoogle Scholar
  25. Papagelopoulos PJ, Peterson HA, Ebersold MJ, Emmanuel PR, Choudhury SN, Quast LM. Spinal column deformity and instability after lumbar or thoracolumbar laminectomy for intraspinal tumors in children and young adults. Spine (Phila Pa 1976). 1997;22:442–51.CrossRefGoogle Scholar
  26. Reuter S, Jensen B, Buttenschoen K, Kratzer W, Kern P. Benzimidazoles in the treatment of alveolar echinococcosis: a comparative study and review of the literature. J Antimicrob Chemother. 2000a;46:451–6.PubMedCrossRefGoogle Scholar
  27. Reuter S, Seitz HM, Kern P, Junghanss T. Extrahepatic alveolar echinococcosis without liver involvement: a rare manifestation. Infection. 2000b;28:187–92.PubMedCrossRefGoogle Scholar
  28. Romig T. Echinococcus multilocularis in Europe-state of the art. Vet Res Commun. 2009;33:31–4.PubMedCrossRefGoogle Scholar
  29. Scarlata F, Giordano S, Saporito L, Marasa L, Li Pani G, Odierna A, Scaglione V, Di Carlo P, Romano A. Cystic hydatidosis: a rare case of spine localization. Infez Med. 2011;19:39–41.PubMedGoogle Scholar
  30. Scheuring UJ, Seitz HM, Wellmann A, Hartlapp JH, Tappe D, Brehm K, Spengler U, Sauerbruch T, Rockstroh JK. Long-term benzimidazole treatment of alveolar echinococcosis with hematogenic subcutaneous and bone dissemination. Med Microbiol Immunol. 2003;192:193–5.PubMedCrossRefGoogle Scholar
  31. Schnepper GD, Johnson WD. Recurrent spinal hydatidosis in North America. Case report and review of the literature. Neurosurg Focus. 2004;17:E8.PubMedGoogle Scholar
  32. Sengul G, Kadioglu HH, Kayaoglu CR, Aktas S, Akar A, Aydin IH. Treatment of spinal hydatid disease: a single center experience. J Clin Neurosci. 2008;15:507–10.PubMedCrossRefGoogle Scholar
  33. Sharma AK, Diyora B, Badhe P, Nayak N, Patankar P, Chopra G. Neurological picture. Primary multiple calvarial hydatid cysts-a rare occurrence. J Neurol Neurosurg Psychiatry. 2011;82:349–50.PubMedCrossRefGoogle Scholar
  34. Spies C, Weisskopf M, Ohnsorge JA. Intraspinal echinococcosis within the lumbar spine of an 18-year-old male patient (in German). Z Orthop Unfall. 2008;146:463–7.PubMedGoogle Scholar
  35. Sudo H, Minami A. Neurological picture. A widespread echinococcosis of the spine. J Neurol Neurosurg Psychiatry. 2010;81:892.PubMedCrossRefGoogle Scholar
  36. Taghipoor M, Razmkon A. Neurological picture. Huge primary intracranial hydatid cysts. J Neurol Neurosurg Psychiatry. 2009;80:1149.PubMedCrossRefGoogle Scholar
  37. Takci E, Sengul G, Akar A, Uslu H, Alper F, Erdogan F, Aydin IH. Alveolar echinococcosis of the brain in five patients. J Clin Neurosci. 2008;15:1105–9.PubMedCrossRefGoogle Scholar
  38. Tappe D, Frosch M, Sako Y, Itoh S, Grüner B, Reuter S, Nakao M, Ito A, Kern P. Close relationship between clinical regression and specific serology in the follow-up of patients with alveolar echinococcosis in different clinical stages. Am J Trop Med Hyg. 2009;80:792–7.PubMedGoogle Scholar
  39. Taratuto AL, Venturiello SM. Echinococcosis. Brain Pathol. 1997;7:673–9.PubMedCrossRefGoogle Scholar
  40. Thaler M, Gabl M, Lechner R, Gstottner M, Bach CM. Severe kyphoscoliosis after primary Echinococcus granulosus infection of the spine. Eur Spine J. 2010;19:1415–22.PubMedCrossRefPubMedCentralGoogle Scholar
  41. Torgerson PR, Schweiger A, Deplazes P, Pohar M, Reichen J, Ammann RW, Tarr PE, Halkik N, Müllhaupt B. Alveolar echinococcosis: from a deadly disease to a well-controlled infection. Relative survival and economic analysis in Switzerland over the last 35 years. J Hepatol. 2008;49:72–7.PubMedCrossRefGoogle Scholar
  42. Toussaint F, Pere P, Le Chaffotec L, Grandhaye P, Pourel J, Chary-Valckenaere I. Alveolar echinococcosis of the spine. J Clin Rheumatol. 2001;7:248–51.PubMedCrossRefGoogle Scholar
  43. Turgut M. Hydatid disease of the spine: a survey study from Turkey. Infection. 1997;25:221–6.PubMedCrossRefGoogle Scholar
  44. Turgut M, Turgut AT. Spinal intradural extramedullary hydatidosis: report of 3 cases. Neurosurgery. 2010;67:E1471–2.PubMedCrossRefGoogle Scholar
  45. Turtas S, Viale ES, Pau A. Long-term results of surgery for hydatid disease of the spine. Surg Neurol. 1980;13:468–70.PubMedGoogle Scholar
  46. Viljoen H, Crane J. Hydatid disease of the spine. Spine (Phila Pa 1976). 2008;33:2479–80.CrossRefGoogle Scholar
  47. Vuitton DA. Benzimidazoles for the treatment of cystic and alveolar echinococcosis: what is the consensus? Expert Rev Anti Infect Ther. 2009;7:145–9.PubMedCrossRefGoogle Scholar
  48. Wang J, Cai B, You C. Surgical treatment options for cerebral alveolar echinococcosis: experience in six patients. Neurol India. 2009;57:157–61.PubMedCrossRefGoogle Scholar
  49. WHO. Guidelines for treatment of cystic and alveolar echinococcosis in humans. WHO Informal Working Group on Echinococcosis. Bull World Health Organ. 1996;74:231–42.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Klinik und Poliklinik für Unfallchirurgie, Klinikum Rechts der IsarTechnische Universitaet MuenchenMuenchenGermany

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