Orthopaedic Surgery, Dean Basrah Medical College, Basrah, Iraq.
Int Orthop. 2012 Feb;36(2):427-32. doi: 10.1007/s00264-011-1480-7. Epub 2012 Jan 21.
The author presents this prospective study of nine cases of pathologically confirmed spinal hydatid disease.
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.
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.
Diagnosis was easy from the start, but eradication was difficult, and recurrence rate was very high despite the use of chemotherapy.
作者提出了这项前瞻性研究，共纳入 9 例经病理证实的脊柱包虫病患者。
在非流行地区，包虫病的诊断较为困难，但在流行地区，应将其纳入脊柱病变的鉴别诊断。脊柱受累非常罕见，没有任何典型的脊柱受累表现。2001 年 9 月至 2010 年 10 月期间，9 例脊柱包虫病患者接受了手术治疗。所有患者均接受了临床评估以及最新的影像学、血液学和血清学检查。所有患者均接受了减压手术，其中 3 例还接受了经皮椎弓根固定术。术后所有患者均接受了阿苯达唑和吡喹酮治疗，疗程为 10 个月。
MRI 是最佳的诊断检查方法，CAT 扫描也有帮助，嗜酸性粒细胞增多是常见的发现，5 例患者的 ESR 高于正常值。所有患者均接受了减压椎板切除术和清除术，其中 3 例患者还接受了经皮椎弓根固定术。术后，1 例患者完全恢复，无复发，7 例患者随时间推移出现复发，残留疾病，1 例患者术后 24 小时内死亡。
从一开始诊断就很容易，但尽管使用了化疗，清除仍然很困难，复发率很高。
