Spinal Hydatid Disease of Cervico-Thoracic in Pregnant Women: A Case Report and Review

Abstract

Background. Spinal hydatid disease is an extremely rare pathology that could leads to the serious orthopedics and neurological complications. Conservative antimicrobial therapy is not effective for spinal echinococcus. This case is unique for the next reasons: disease manifestation during pregnancy, a long period from a spine decompression to a reconstruction procedure and a technique of the surgery. Case description. A 27 year-old lady at 34 gestation weeks, previously operated on the urgent indications of paraplegia with neurogenic bladder dysfunction after 1 year and 10 months follow-up suffered vertebral column reconstruction due to recurrence of the cervico-thoracic hydatid disease, complicated by angular kyphosis. The echinococcus cyst had a closed contact with a right brachiocephalica vein, compressed the spinal canal and leads to three-column spine instability. Conclusion. Three-column spine reconstruction with anterior corpectomy, cystectomy and fusion provide resolution of the back pain syndrome, improve neurological status and achieve local control of the infectious process in patients with echinococcosis of the spine. In the postoperative period, staged therapy with antiparasitic drugs should be prescribe.