Argenson C, Griffet J, Lacour C, Arcamone H, Lovet J, de Peretti F
Service d'Orthopédie-Traumatologie, Hôpital Saint-Roch, Nice.
Rev Chir Orthop Reparatrice Appar Mot. 1989;75(4):267-70.
The hydatid disease is rare in osseous locations, especially in our country (2.2 per cent). It has some particularities: clinical latency, diagnosis difficulties, surgical treatment often unsatisfactory because of the difficulty of total excision. Pain and sometimes deformity are often the only clinical features at the beginning of the disease. But, the evolution is unfavourable as soon as neurological symptoms appear. Multiple recurrences lead to unavoidable paraplegia. The antihelminthic drug (mebendazole) is disappointing in osseous location. Surgery is the only hope but the excision must be carcinologic. Spinal instrumentation can be improved by the use of acrylic cement whereas osseous grafts can be invaded by hydatidosis extension or recurrence. At present, the prognosis is still poor with constant apparition of cord compression. The authors report two cases of patients with osseous hydatidosis of the spine which illustrate these difficulties.
骨包虫病在骨骼部位较为罕见,在我国尤其如此(占2.2%)。它具有一些特殊性:临床潜伏期长、诊断困难、由于难以完全切除,手术治疗往往不尽人意。疼痛以及有时出现的畸形常常是该病初期仅有的临床特征。但是,一旦出现神经症状,病情进展就会不利。多次复发会导致不可避免的截瘫。抗蠕虫药物(甲苯达唑)在骨骼部位的治疗效果令人失望。手术是唯一的希望,但切除必须是根治性的。使用丙烯酸骨水泥可改善脊柱内固定,而骨移植可能会被包虫病的扩展或复发侵犯。目前,由于脊髓压迫不断出现,预后仍然很差。作者报告了两例脊柱骨包虫病患者的病例,这些病例说明了这些困难。