Diagnose, treatment and diagnostic pitfalls of spinal echinococcosis

Objective To critically examine and elucidate the characteristics of clinical manifestation and images, the diagnose, treatment and diagnostic pitfalls of spinal echinococcosis. Methods All the cases were treated with debridement operations, and some of them received autogenetic, allogenetic bone graft or bone cement was used to fill the defect. Albendazole (In doses 20 mg/kg/day or liposomal albendazole 10 mg/kg/day) was used to prevent relapse for 3 months after operation. Analyze the characteristics of spinal echinococcosis from clinical manifestation, Epidemiology, Imageology and Immunology, then the diagnose and treatments were summarized. Results Eighteen cases were available for follow up. The period ranging from 0. 5 to 15 years with an average of 3. 6 years, and 11 cases had relapsed (61%). The relapsed lesion was located in the cervical vertebrae in 1 case for 3 times, the thoracic vertebrae in 4, the lumbar vertebrae in 2 and the sacrum in 4 cases. The nerve system symptoms were in sixteen cases, according to Frankel Grade; 1 in A, 3 in B, 3 in C and 9 in D. The symptoms had been improved differently after operation. Conclusion Whereas X-ray or CT images of spinal echinococcosis are similar to tuberculosis, metastases, giant cell tumor, or cyst of bone, MRI shows distinctive diagnostic features of spinal hydatid disease. Serological examinations are important to confirm the correct diagnosis. The symptoms caused by compressed spinal cord can be improved by lesion debridement operations. Spinal echinococcosis is easy relapsed after operation even with chemotherapeutic treatment.