Recurrent paraplegia caused by spinal echinococcosis
Sapkas, G.S.; Papagelopoulos, P.J.; Stathakopoulos, D.P.; Babis, G.C.; Tzagarakis, G.P.; Kateros, K.T.
Orthopedics 25(10): 1087-1088
2002
ISSN/ISBN: 0147-7447 PMID: 12401017 Document Number: 542287
A 54-year-old woman presented with acute incomplete paraplegia, with neurological deficit below T9 [Greece]. Three years prior to presentation, the patient was also hospitalized for acute incomplete paraplegia, and following decompressive laminectomies, was discharged well with full neurological recovery. Presently, the patient had incomplete paraplegia with neurological deficit below T9 and deficit of the anal sphincter reflex. Plain radiographs showed osteolytic lesions of the T9 and T10 vertebrae. Computed tomography showed destruction of the 9th and 10th thoracic vertebral bodies with significant soft tissue involvement. Two cysts were also evident in the spinal cord compressing the spinal cord anterolaterally from both sides. Myelography and CT myelography revealed a complete block at T9-T10. A two-stage operative procedure was performed, with collection of samples from the two cysts. Histological examination revealed multilocullar Echinococcus lesions. Postoperatively, the patient was treated with mebendazole for 3 months. Gradual improvement of the neurological status was noted. Five months postoperatively, the patient was pain free and showed further neurological improvement. However, the patient developed complete paraplegia due to recurrence of hydatid disease one year postoperatively. She refused further treatment and died 2 years later.