Although rare, spinal
hydatid disease is a manifestation of hydatid infestation. The authors present the report of a patient who presented with primary spinal
hydatid disease. This disease is often misdiagnosed as tuberculous
spondylitis, and thus patients may subsequently receive inappropriate treatment. The patient in this case presented, with an increasing weakness in the lower limbs, to a different clinic from an area in India where hydatid
infections are endemic. The
infection was misdiagnosed as tuberculous spondolytis based on evaluation of plain
x-ray films, and the patient underwent antituberculous
chemotherapy and a posterior surgical decompressive procedure. The patient presented to the authors' clinic with increasing
paraparesis 1.5 years later. Radiographs and a magnetic resonance image of the spine were obtained, which strongly suggested
hydatid disease. Examination of serum levels confirmed the diagnosis. The patient underwent a decompressive procedure of the spine in which stabilization was performed. Postoperatively her
paraparesis resolved, and good control over the disease was achieved by
chemotherapy. The authors conclude that primary spinal
hydatid disease of the spine, although a rare manifestation, should be considered in the differential diagnosis in patients with infectious and destructive lesions of the spine in regions in which the disease is endemic. Advanced imaging studies should be performed to diagnose the disease. Early decompressive surgery with stabilization of the spine, in addition to
adjuvant chemotherapy, is the treatment of choice for these patients.