Jamshidi Khodamorad, Zandrahimi Farshad, Haji Agha Bozorgi Milad, Mirkamali Seyed Farzam, Esmaeli Dahaj Abbas, Mirzaei Alireza
Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.
Kerman University of Medical Sciences, Kerman, Iran.
Arch Bone Jt Surg. 2022 May;10(5):447-452. doi: 10.22038/ABJS.2021.54448.2717.
Extra-spinal osseous hydatid disease is reported in a small number of case series. In the present study, we report our experience with extra-spinal hydatid disease of the bone in a series of nine patients.
In this retrospective study, the patients who were diagnosed with an extra-spinal osseous hydatid disease were included. All patients were treated surgically. Preoperative anthelmintic drugs were employed for the cysts that were diagnosed before the operation. Postoperative chemotherapy was performed for all patients.
The study population included nine patients, including seven males and two females, with a mean age of 45.2±7.9 years and an average follow-up of 4.1±2.7 years. Non-specific pain was the most common symptom at presentation. Pelvic bones were the most frequent site of involvement. Serologic tests were false negative in seven patients. The disease was diagnosed preoperatively in five patients, and all of them were located in flat bones. The cysts were treated by radical excision in four patients, extended curettage in four patients, and amputation in one patient. The recurrence of the lesion was recorded in two patients who were treated by intralesional curettage. One case of suppuration was the only postoperative complication of this series.
Osseous hydatid disease is a serious disease with challenging diagnosis, difficult treatment, and significant morbidity. Preoperative diagnosis is generally easier in flat bones. Radical resection is the optimal treatment of this disease, while non-radical resection is associated with a higher risk of recurrence.
脊柱外骨包虫病仅在少数病例系列中有报道。在本研究中,我们报告了一组9例脊柱外骨包虫病患者的治疗经验。
本回顾性研究纳入了诊断为脊柱外骨包虫病的患者。所有患者均接受手术治疗。对术前诊断出的囊肿使用术前驱虫药物。所有患者均进行术后化疗。
研究人群包括9例患者,其中男性7例,女性2例,平均年龄45.2±7.9岁,平均随访4.1±2.7年。非特异性疼痛是最常见的首发症状。骨盆骨是最常受累的部位。7例患者血清学检查呈假阴性。5例患者术前确诊,且均位于扁骨。4例患者的囊肿采用根治性切除治疗,4例患者采用扩大刮除术,1例患者采用截肢术。2例接受病灶内刮除术治疗的患者出现病变复发。1例化脓是该系列唯一的术后并发症。
骨包虫病是一种严重疾病,诊断具有挑战性,治疗困难,发病率高。扁骨的术前诊断通常更容易。根治性切除是本病的最佳治疗方法,而非根治性切除复发风险较高。