Isolated Sacral Extradural Hydatid Cyst with Posterior Paravertebral Extension Presenting as a Cauda Equina Syndrome
Published: September 1, 2018 | DOI: https://doi.org/10.7860/JCDR/2018/36178.11979
Bigyan Bhandari, Binod Bijukachhe, Prashant Adhikari, Yogesh Acharya
1. Consultant Orthopedic and Spine Surgeon, Department of Orthopedics, Grande International Hospital, Kathmandu, Nepal.
2. Consultant, Department of Orthopedics, Grande International Hospital, Kathmandu, Nepal.
3. Consultant Orthopedic and Spine Surgeon, Department of Orthopedics, Grande International Hospital, Kathmandu, Nepal.
4. Assistant Professor, Department of Epidemiology and Preventive Health, Avalon University School of Medicine, Willemstad, Netherlands.
Correspondence
Dr. Yogesh Acharya,
Avalon University School of Medicine, Santa Rosaweg 122-124,
Willemstad, Curacao, Netherland Antilles., Willemstad, Netherlands.
E-mail: dryogeshach@gmail.com
Hydatid disease is a ubiquitous parasitic zoonotic disease caused by Echinococcus granulosus. Humans are the accidental intermediate host and it primarily affect the liver and lungs. Isolated primary spinal hydatid disease is an uncommon variant of the musculoskeletal echinococcosis. Dorsal and lumbar spines are commonly affected. We present a rare case report of sacral intraspinal, extradural and posterior paravertebral hydatid cyst with soft tissue extension presenting as a cauda equine syndrome. The patient was started with on oral albendazole and surgery planned. Histopathological examination was consistent with hydatid cyst. The patient showed significant improvement in symptoms after the surgery with an uneventful postoperative course. There were no signs of recurrence in an interval Magnetic Resonance Imaging (MRI). Hydatid disease of the spine possesses a diagnostic and therapeutic challenge due to its varied presentation and difficult approach. Despite a significant advancement in diagnostic techniques and available pharmacological and non-pharmacological treatment modalities, it is associated with a high recurrence rate and increased morbidity.
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