Medical Imaging Center, Xinjiang Medical University Affiliated First Hospital, Urumqi, 830054, People's Republic of China.
State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, People's Republic of China.
Int Orthop. 2023 May;47(5):1153-1162. doi: 10.1007/s00264-023-05731-y. Epub 2023 Feb 24.
Echinococcosis remains a major economic and severe public health problem in endemic areas. Bone echinococcosis is rare, and the vertebra and pelvis are the most common sites of echinococcosis involving the skeletal. Because of the clinical severe symptoms and high recurrence rate, it brings excellent trouble to patients.
This study retrospectively analyzed the clinical manifestations, laboratory tests, radiological findings, and treatment of 44 patients with vertebral and pelvic echinococcosis during a period of 16 years (2005-2020).
The mean age was 43 years (25 males, 19 females; 19-68 years). The most common symptom was pain, followed by numbness, weakness, activity limitation, and progressive paraparesis. Enzyme-linked immunosorbent assay test (ELISA) results were positive in 18 cases (75%). There are 24 cases of hydatid infection of the spine, 14 hydatid infection of the pelvis, and six hydatid infection of both vertebra and pelvis. The site of infection was 13 (29.5%) thoracic, five (11.4%) lumbar, four (9.1%) lumbosacral, seven (15.9%) sacral, 19 (43.2%) ilium, seven (15.9%) hip, six (13.6%) ischium, five (11.4%) pubis, and two (4.5%) femur, respectively. The imaging findings were cystic dilatancy, septal, and irregular bone destruction. MRI has a special value in showing the relationship between the surrounding tissues and organs of cystic bone echinococcosis. All patients were followed up for at least one year. The mean follow-up time was 3.6 years.
Even in epidemic areas, the incidence of bone echinococcosis is relatively rare. However, when encountering the vertebral and pelvic destruction, consider bone echinococcosis's possibility, especially for the herdsmen in endemic regions.
包虫病仍然是流行地区的一个主要经济和严重的公共卫生问题。骨包虫病较为罕见，而脊柱和骨盆是包虫病累及骨骼的最常见部位。由于临床症状严重且复发率高，给患者带来极大困扰。
本研究回顾性分析了 16 年间（2005-2020 年） 44 例脊柱和骨盆包虫病患者的临床表现、实验室检查、影像学表现和治疗方法。
患者平均年龄为 43 岁（25 名男性，19 名女性；年龄 25-68 岁）。最常见的症状是疼痛，其次是麻木、无力、活动受限和进行性截瘫。酶联免疫吸附试验（ELISA）结果阳性 18 例（75%）。脊柱包虫感染 24 例，骨盆包虫感染 14 例，脊柱和骨盆均有包虫感染 6 例。感染部位 13 例（29.5%）为胸椎，5 例（11.4%）为腰椎，4 例（9.1%）为腰骶椎，7 例（15.9%）为骶骨，19 例（43.2%）为髂骨，7 例（15.9%）为髋骨，6 例（13.6%）为坐骨，5 例（11.4%）为耻骨，2 例（4.5%）为股骨。影像学表现为囊状扩张、分隔和不规则骨破坏。MRI 对显示囊状骨包虫病与周围组织和器官的关系具有特殊价值。所有患者均至少随访 1 年，平均随访时间为 3.6 年。
即使在流行地区，骨包虫病的发病率也相对较低。然而，当遇到脊柱和骨盆破坏时，应考虑骨包虫病的可能性，特别是在流行地区的牧民。
