Treatment of progressive cervical spinal instability secondary to hydatid disease : A case report

A case report of a patient with progressive cervical spinal instability secondary to hydatid disease and the operative therapy. To document how the combination of contemporary imaging, medical, and operative methods has obviated severe neurologic sequelae in a patient's cervical spine ravaged by hydatidosis. The incidence of hydatid disease in the vertebral column is unusual and rare in the cervical spine. Until recently, patients with spinal hydatid disease have had guarded prognoses, because the various medical and surgical therapies could not effect curative or even palliative results. The use of contemporary imaging methods, including computed tomography and magnetic resonance imaging, is described, in conjunction with current anthelminthic therapy and operative spinal instrumentation in this patient with recurrent quadriparesis from progressive hydatid spinal erosion. With the operative and medical therapies described in this case report, the patient has had six successful operative results in 6 years for cervical spinal hydatidosis and remains neurologically normal, with a stable cervical spine. It is hoped that this case presentation will justify a spirit of guarded optimism in the patient whose spine has been rendered unstable by hydatid disease and that, though a cure is still not likely, at least the past inexorable prognosis of paralysis and death is ameliorated.