Caglar Yusuf Sukru, Ozgural Onur, Zaimoglu Murat, Kilinc Cemil, Eroglu Umit, Dogan Ihsan, Kahilogullari Gokmen
Department of Neurosurgery, Ankara University School of Medicine, Ankara, Turkey.
J Korean Neurosurg Soc. 2019 Mar;62(2):209-216. doi: 10.3340/jkns.2017.0245. Epub 2019 Feb 27.
Hydatid cyst disease is caused by the parasite Echinococcus granulosus. It is rarely seen in the vertebral system, occurring at a rate of 0.2-1%. The aim of this study is to present 12 spinal hydatid cyst cases, and propose a new type of drainage of the cyst.
Twelve cases of spinal hydatid cysts, surgical operations, multiple operations, chronic recurrences, and spinal hydatic cyst excision methods are discussed in the context of the literature. Patients are operated between 2005 and 2016. All the patients are kept under routine follow up. Patient demographic data and clinicopathologic characteristics are examined.
Six male and six female patients with a median age of 38.6 at the time of surgery were included in the study. Spinal cyst hydatid infection sites were one odontoid, one cervical, five thoracic, two lumbar, and three sacral. In all cases, surgery was performed, with the aim of total excision of the cyst, decompression of the spinal cord, and if necessary, stabilization of the spinal column. Mean follow up was 61.3 months (10-156). All the patients were prescribed Albendazole. Three patients had secondary hydatid cyst infection (one lung and two hepatic).
The two-way drainage catheter placed inside a cyst provides post-operative chlorhexidine washing inside the cavity. Although a spinal hydatid cyst is a benign pathology and seen rarely, it is extremely difficult to achieve a real cure for patients with this disease. Treatment modalities should be aggressive and include total excision of cyst without rupture, decompression of spinal cord, flushing of the area with scolicidal drugs, and ensuring spinal stabilization. After the operation the patients should be kept under routine follow up. Radiological and clinical examinations are useful in spotting a recurrence.
包虫囊肿病由细粒棘球绦虫寄生虫引起。在脊椎系统中很少见，发生率为0.2 - 1%。本研究的目的是介绍12例脊柱包虫囊肿病例，并提出一种新型的囊肿引流方法。
结合文献讨论了12例脊柱包虫囊肿病例、手术操作、多次手术、慢性复发以及脊柱包虫囊肿切除方法。患者于2005年至2016年接受手术。所有患者均接受常规随访。检查患者的人口统计学数据和临床病理特征。
本研究纳入了6例男性和6例女性患者，手术时的中位年龄为38.6岁。脊柱囊肿包虫感染部位为1例齿状突、1例颈椎、5例胸椎、2例腰椎和3例骶椎。所有病例均进行了手术，目的是完全切除囊肿、脊髓减压，必要时进行脊柱稳定。平均随访时间为61.3个月（10 - 156个月）。所有患者均服用阿苯达唑。3例患者发生继发性包虫囊肿感染（1例肺部和2例肝脏）。
置于囊肿内的双向引流导管可在术后对囊腔内进行洗必泰冲洗。尽管脊柱包虫囊肿是一种良性病变且很少见，但要真正治愈这种疾病的患者极其困难。治疗方式应积极，包括完整切除囊肿而不破裂、脊髓减压、用杀头节药物冲洗该区域以及确保脊柱稳定。术后患者应接受常规随访。放射学和临床检查有助于发现复发情况。
