Treatment of Vertebral Hydatidosis and Factors Influencing Local Recurrence: A Systematic Review
Abstract
Background: Bone hydatidosis is rare, but approximately half of the cases involve the spine. Treatment is challenging because of the complexity of the lesions and adjacent structures; moreover, local recurrence rates are high. The aim of this review was to describe the outcomes of surgical treatments in patients with vertebral hydatidosis and to evaluate factors associated with recurrence. Materials and Methods: A systematic review of articles addressing the surgical treatment of vertebral hydatidosis was performed. Data collected included characteristics of cystic lesions, type of surgery performed, and postoperative outcomes. Results: Data from 99 patients were analyzed. The most frequent presentation was extradural intraspinal involvement of the thoracic spine; 74.5% of patients presented with incomplete neurological deficits. Decompression surgery, resection of cysts, and spinal stabilization were performed in 75% of cases, and all patients received postoperative albendazole therapy. All patients experienced symptomatic improvement, although 27.9% did not achieve complete recovery. Among patients with follow-up longer than one year, 76% developed local recurrence. An association was found between the type of surgery performed and local recurrence (p = 0.05). Conclusions: Vertebral hydatidosis is a rare disease with slow progression and potential neurological complications. When selecting the surgical approach, lesion location, neurological involvement, and spinal stability should be considered. Recurrence is a frequent complication; however, a definitive predisposing cause could not be identified.Downloads
References
WHO. World Health Statistics 2015. Geneva: World Health Organization; 2015, p. 162.
Gezercan Y, Ökten AI, Çavuş G, Açık V, Bilgin E. Spinal hydatid cyst disease. World Neurosurg 2017;108:407-17.
https://doi.org/10.1016/j.wneu.2017.09.015
Liang Q, Xiang H, Xu L, Wen H, Tian Z, Yunus A, et al. Treatment experiences of thoracic spinal hydatidosis: a
single-center case-series study. Int J Infect Dis 2019; 89:163-8. https://doi.org/10.1016/j.ijid.2019.09.024
Meng Y, Ren Q, Xiao J, Sun H, Huang Y, Liu Y, et al. Progress of research on the diagnosis and treatment of bone cystic echinococcosis. Front Microbiol 2023;14:1273870. https://doi.org/10.3389/fmicb.2023.1273870
Neumayr A, Tamarozzi F, Goblirsch S, Blum J, Brunetti E. Spinal cystic echinococcosis--a systematic analysis and
review of the literature: part 1. Epidemiology and anatomy. PLoS Negl Trop Dis 2013;7(9):e2450.
https://doi.org/10.1371/journal.pntd.0002450
Cattaneo L, Manciulli T, Cretu CM, Giordani MT, Angheben A, Bartoloni A, et al. Cystic echinococcosis of the
bone: A European Multicenter Study. Am J Trop Med Hyg 2019;100(3):617-21. https://doi.org/10.4269/ajtmh.18-0758
Kaloostian PE, Gokaslan ZL. Spinal hydatid disease: a multidisciplinary pathology. World Neurosurg 2015;83(1):52-3. https://doi.org/10.1016/j.wneu.2013.07.106
Luan H, Liu K, Deng Q, Sheng W, Maimaiti M, Guo H, et al. Multiple debridement of cavity lesions combined with antiparasitic chemotherapy in the treatment of mid or advanced spinal echinococcosis: a retrospective study of 33 patients. Int J Infect Dis 2022;114:261-7. https://doi.org/10.1016/j.ijid.2021.11.014
Braithwaite PA, Lees RF. Vertebral hydatid disease: radiological assessment. Radiology 1981;140(3):763-6.
https://doi.org/10.1148/radiology.140.3.7280247
Liu P, Feng H, Liu J. A case of extensive thoracolumbar spinal intradural cystic echinococcosis. World Neurosurg 2022;165:89-90. https://doi.org/10.1016/j.wneu.2022.06.034
Villanueva FJS, Barbieri SL, Gallardo FA. Hidatidosis vertebral intrarraquídea. Una patología médico-quirúrgica. Reporte de dos casos. Rev Asoc Argent Ortop Traumatol 2020;85(1):56-64. https://doi.org/10.15417/issn.1852-7434.2020.85.1874
Velasco JM, Sapriza S, Galli N, García F. Vertebral hydatidosis: bibliographical review and clinical case report.
Coluna/Columna 2018;17(4):326-9. https://doi.org/10.1590/S1808-185120181704191824
El Hammoumi MM, El Mostarchid B, Kabiri EH. Posterior approach to intrathoracic hydatid cyst invading the
dorsal spine. Arch Bronconeumol 2015;51(11):600-1. https://doi.org/10.1016/j.arbres.2015.05.011
Abdelhakim K, Khalil A, Haroune B, Oubaid M, Mondher M. A case of sacral hydatid cyst. Int J Surg Case Rep
;5(7):434-6. https://doi.org/10.1016/j.ijscr.2014.03.025
Kafaji A, Al-Zain T, Lemcke J, Al-Zain F. Spinal manifestation of hydatid disease: a case series of 36 patients. World Neurosurg 2013;80(5):620-6. https://doi.org/10.1016/j.wneu.2013.06.013
Sioutis S, Reppas L, Bekos A, Soulioti E, Saranteas T, Koulalis D, et al. Echinococcosis of the spine. EFORT Open
Rev 2021;6(4):288-96. https://doi.org/10.1302/2058-5241.6.200130
Neumayr A, Tamarozzi F, Goblirsch S, Blum J, Brunetti E. Spinal cystic echinococcosis--a systematic analysis and review of the literature: part 2. Treatment, follow-up and outcome. PLoS Negl Trop Dis 2013;7(9):e2458.
https://doi.org/10.1371/journal.pntd.0002458
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