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Peruvian Journal of Neurosurgery

Vertebral hydatidosis: case report

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Introduction: Vertebral hydatid cyst is a rare disease with an incidence rate of 0.2-1%. In the spinal cord, it can cause pain and severe disability due to compression and instability. Magnetic resonance imaging (MRI) shows characteristic lesions in T1 and T2. The combination of medical anthelmintic treatment and surgery for cyst excision is the most used strategy.
Clinical Case: A 47-year-old woman with a history of surgery for hepatic hydatidosis associated with intraoperative rupture, with a 7-month history of the disease characterized by oppressive back pain, belt-like back pain, and of increasing intensity up to 10/10, associated with paresthesia in the lower limbs and urinary retention. The MRI revealed a multicystic process in the D5 vertebral body with the invasion of the posterior mediastinum and the spinal canal. The diagnosis was confirmed serologically with IgM and IgG. A D5 corpectomy and excision of the cystic lesion were performed using a D5-D6 costotransversectomy; in addition, a D3-D4 and D6-D7 transpedicular fixation and a D5 body replacement with cylindrical mesh were performed. The evolution was favorable without evidence of recurrence one month after surgery.
Conclusion: Vertebral hydatidosis is a rare pathology that requires surgical management combined with prolonged medical treatment with albendazole. Surgery is complex because the presence of multicystic lesions makes extensive surgical resection without rupture of the cyst membrane difficult. Close monitoring of these patients allows detection of recurrence and favors its early management.
          Keywords: Echinococcosis, Spinal Cord, Back Pain, Albendazole, Surgical Mesh (Source: MeSH NLM)