The Spine Journal 15 (2015) e37–e38
Evaluation of recurrent vertebral hydatid cyst with computed tomography myelography in a case with spinal instrumentation A 31-year-old female patient has been evaluated for back pain unresponsive to medical therapy. She had been operated two times for cystic lesions on her thoracic vertebrae. The lesion was diagnosed as hydatid cyst with regard to its macroscopic appearance and pathologic
evaluation. Recurrent back pain, progressive numbness, and weakness emerged on her right lower extremity while she was having medical therapy. The operation site could not be evaluated with magnetic resonance imaging optimally because of intense artifacts caused by previous vertebral instrumentation. For this reason, computed tomography myelography was made, and the relevant thoracic segment was demonstrated clearly. A cystic lesion involving the body, right pedicle, and partially lamina of T8 vertebra, compressing the spinal cord by extending through the spinal canal was found to be compatible with recurrent hydatid cyst. No malposition or fracture was observed in stabilization materials (Figure 1).
Figure 1. Spinal cord and surrounding tissues cannot be evaluated because of artifacts on T2-weighted sagittal MR images (Left), but a paraspinal cystic lesion (c) is seen (Right). Spinal instruments and spinal stenosis causing mass (arrow) are seen on CT myelography VRT images (Middle). Metallic materials, hydatid cyst at the level of stenosis (Right), and cord compression (arrow) are seen on sagittal and axial reformatted CT myelography images acquired from different levels (red lines 1, 2 and 3). Spinal cord (dashed arrow), contrast media in the subarachnoid space (*). http://dx.doi.org/10.1016/j.spinee.2015.06.069 1529-9430/Ó 2015 Elsevier Inc. All rights reserved.
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B. Sanal et al. / The Spine Journal 15 (2015) e37–e38
Bekir Sanal, MDa Omer Fatih Nas, MDb Ramazan Buyukkaya, MDc Kadir Hacikurt, MDb Bahattin Hakyemez, MDb a Department of Radiology Dumlupinar University Faculty of Medicine Kutahya, Turkey b Department of Radiology Uludag University Faculty of Medicine Bursa, Turkey
c
Department of Radiology Duzce University Faculty of Medicine Duzce, Turkey FDA device/drug status: Not applicable. Author disclosures: BS: Nothing to disclose. OFN: Nothing to disclose. RB: Nothing to disclose. KH: Nothing to disclose. BH: Nothing to disclose. The authors declare that they have no conflicts of interest.
Evaluation of recurrent vertebral hydatid cyst with computed tomography myelography in a case with spinal instrumentation A 31-year-old female patient has been evaluated for back pain unresponsive to medical therapy. She had been operated two times for cystic lesions on her thoracic vertebrae. The lesion was diagnosed as hydatid cyst with regard to its macroscopic appearance and pathologic
evaluation. Recurrent back pain, progressive numbness, and weakness emerged on her right lower extremity while she was having medical therapy. The operation site could not be evaluated with magnetic resonance imaging optimally because of intense artifacts caused by previous vertebral instrumentation. For this reason, computed tomography myelography was made, and the relevant thoracic segment was demonstrated clearly. A cystic lesion involving the body, right pedicle, and partially lamina of T8 vertebra, compressing the spinal cord by extending through the spinal canal was found to be compatible with recurrent hydatid cyst. No malposition or fracture was observed in stabilization materials (Figure 1).
Figure 1. Spinal cord and surrounding tissues cannot be evaluated because of artifacts on T2-weighted sagittal MR images (Left), but a paraspinal cystic lesion (c) is seen (Right). Spinal instruments and spinal stenosis causing mass (arrow) are seen on CT myelography VRT images (Middle). Metallic materials, hydatid cyst at the level of stenosis (Right), and cord compression (arrow) are seen on sagittal and axial reformatted CT myelography images acquired from different levels (red lines 1, 2 and 3). Spinal cord (dashed arrow), contrast media in the subarachnoid space (*). http://dx.doi.org/10.1016/j.spinee.2015.06.069 1529-9430/Ó 2015 Elsevier Inc. All rights reserved.
e38
B. Sanal et al. / The Spine Journal 15 (2015) e37–e38
Bekir Sanal, MDa Omer Fatih Nas, MDb Ramazan Buyukkaya, MDc Kadir Hacikurt, MDb Bahattin Hakyemez, MDb a Department of Radiology Dumlupinar University Faculty of Medicine Kutahya, Turkey b Department of Radiology Uludag University Faculty of Medicine Bursa, Turkey
c
Department of Radiology Duzce University Faculty of Medicine Duzce, Turkey FDA device/drug status: Not applicable. Author disclosures: BS: Nothing to disclose. OFN: Nothing to disclose. RB: Nothing to disclose. KH: Nothing to disclose. BH: Nothing to disclose. The authors declare that they have no conflicts of interest.
