Medical decompression of vertebral hydatidosis

Study Design. A case report from one of the longest follow-up studies of survivors with spinal hydatid disease. This patient was treated with a combination of albendazole and praziquantel chemotherapy; the results of this form of treatment are reported. Objectives. To demonstrate the efficacy of combination albendazole and praziquantel drug treatment for spinal hydatidosis. Summary of Background Data. Although echinococcal infestation in humans is a world-wide problem, it is rarely seen in the United Kingdom. Between 1% and 2% of all cases involve bone, and 50% of these involve the spine. The condition has a reported mortality rate of more than 50%. The average length of survival of patients with echinococcal infestation in Britain after the onset of symptoms is 5 years, and the average age at death is 41 years. Methods. The patient in this report had undergone multiple spinal debridement operations alongside internal fixation and presented with increasing paraparesis from recurrent disease. Surgery for disease recurrence carries a high risk of mortality. The patient was treated with a preoperative combination of albendazole and praziquantel drug therapy, a novel combination for this condition. Results. Response to treatment was monitored clinically, biochemically, and with serial computed tomography. No serious side effects were observed. Results were very encouraging. After 2 months of treatment she had improved and was able to walk with the aid of a walking frame; therefore, surgery was deferred. Conclusion. The combination of albendazole and praziquantel drug therapy appears to be effective in the conservative treatment of patients with inoperable spinal hydatidosis.