Pooled analysis of 86 published spinal hydatid cyst cases from Turkey

Abstract

Introduction: Spinal hydatid cyst (SHC) is a difficult to treat parasitic infectious disease with high risk of recurrence. Similar with HC the visceral organs, there are no standard treatment protocols for SHC. The aim of this study was to analyze clinical and laboratory findings, treatment, and prognosis in published SHC case reports from Turkey in the last 20 years. Materials and Methods: One national (Ulakbim, Turkish medical literature database, http://uvt.ulakbim.gov.tr/uvt/) and two international databases (www.scopus.com and www.pubmed.com) were searched for SHC case reports from Turkey published in Turkish and international journals between January 1998 and November 2018. Relevant articles were identified using the keywords “spinal kist hidatik” and “vertebral kist hidatik” in the national database and “spinal hydatid cyst and Turkey” and “vertebral hydatid cyst and Turkey” in the international databases. Of 114 articles identified in the initial search, 55 articles that met the study criteria were included in our analysis. The cases were evaluated in terms of presenting symptoms, history, physical examination findings, concurrent extraspinal involvement, diagnostic methods, spinal lesion category, treatment, and prognosis. Results: A total of 86 cases of SHC were identified in the three databases using the specified keywords. Forty-eight (56%) of the patients were male and the mean age was 36.4±16.8 (8-73) years. The most common presenting symptoms were back pain (83%), difficulty in walking (47%), urinary and/or stool incontinence (27%), and leg numbness (22%). Concurrent extraspinal involvement was identified in 35% of the patients while thoracic involvement was the most common (36%). Extradural intraspinal was the most common lesion type. The most preferred treatment protocol was albendazole for a duration of six months. When the history and follow-up period of the patients were evaluated together, 51% of the patients had at least one recurrence. Conclusion: SHC affects the young to middle-aged population, leading to neurological morbidities that decrease patients’ quality of life. Studies are needed to determine more effective medical treatment protocols for SHC.