Ozdemir Haci Mustafa, Ogün Tunç Cevat, Tasbas Bülent
Department of Orthopedics and Traumatology, Meram School of Medicine, Selçuk University, Konya, Turkey.
Spine (Phila Pa 1976). 2004 Apr 15;29(8):932-7. doi: 10.1097/00007632-200404150-00022.
Retrospective evaluation of patients with primary hydatid disease was done, with an overview of the pertinent literature. OBJECTIVES.: To determine the results of surgical decompression and antihelminthic treatment.
Bone involvement in hydatid disease has been reported to be only 0.5 to 4%. Spinal involvement is found in 50% of these cases, with mortality over 50%. Paraplegia is the most serious complication of the disease, caused by compression of the spinal cord by the cysts. Aggressive surgery combined with antihelminthic therapy is recommended to eradicate the disease and prevent recurrence.
Three patients with primary spinal hydatid disease were operated on several times for multiple recurrences. Combined chemotherapy with either mebendazole or albendazole was also given. The mean age was 52 years, and the mean follow-up time was 92 months.
Surgery and chemotherapy improved the symptoms in all cases but could not prevent recurrences and multiple operations.
Primary spinal echinococcosis must be considered in the preoperative differential diagnosis of the atypical presentation of vertebral lesions, especially in patients with risk factors. Early diagnosis and preferably anterior radical surgery combined with antihelminthic therapy of sufficient duration are mandatory to at least halt the progression of symptoms, but these measures could not provide a lasting solution for the patients described here.
对原发性包虫病患者进行回顾性评估，并对相关文献进行综述。目的：确定手术减压和抗蠕虫治疗的效果。
据报道，包虫病累及骨骼的比例仅为0.5%至4%。其中50%的病例累及脊柱，死亡率超过50%。截瘫是该疾病最严重的并发症，由囊肿压迫脊髓所致。建议采用积极的手术联合抗蠕虫治疗以根除疾病并预防复发。
3例原发性脊柱包虫病患者因多次复发接受了多次手术。同时给予甲苯达唑或阿苯达唑联合化疗。平均年龄为52岁，平均随访时间为92个月。
手术和化疗在所有病例中均改善了症状，但无法预防复发和多次手术。
在术前对椎体病变的非典型表现进行鉴别诊断时，尤其是对有危险因素的患者，必须考虑原发性脊柱棘球蚴病。早期诊断，最好采用前路根治性手术联合足够疗程的抗蠕虫治疗，至少可以阻止症状进展，但这些措施无法为本文所述患者提供持久的解决方案。
