{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T06:38:33Z","timestamp":1776753513902,"version":"3.51.2"},"reference-count":23,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Spinal hydatid disease frequently poses significant surgical challenges and leads to severe neurological complications. Despite the development of various surgical techniques, recurrence remains a common issue. The aim of this study was to evaluate the impacts of radical vertebrectomy on recurrence and long-term follow-up outcomes by comparing total en-bloc spondylectomy with conventional laminectomy, decompression, and posterior stabilisation in patients treated at our centre. Methods: This study included 21 patients who underwent surgery for spinal hydatid cysts at our centre between 2001 and 2021. Twelve patients had cystectomy, laminectomy, decompression, and stabilisation, and nine patients had total en-bloc spondylectomy. A single senior surgeon carried out each procedure, selecting the surgical approach based on the presence of vertebral body involvement. All patients received albendazole treatment for six months following surgery. The surgeon who performed the operations followed up all patients clinically and radiologically for at least three years. Results: Seven out of twelve patients (58.3%) who had conventional surgery experienced recurrences, while total en-bloc spondylectomy produced no recurrences (p = 0.004). The recurrent cases had a mean of 2.8 surgical procedures and manifested within 14 months. Although total en-bloc spondylectomy was associated with a longer operative time and greater blood loss, neurological recovery and overall clinical outcomes were comparable between the two groups. The difference in the recurrence rate was statistically significant. Conclusions: Although technically demanding, radical vertebrectomy is shown to provide complete protection against recurrence in appropriately selected patients with spinal hydatid disease in this study. Furthermore, as conservative approaches often require multiple procedures, total en-bloc spondylectomy can be considered an effective treatment for patients with vertebral body involvement.<\/jats:p>","DOI":"10.3390\/jcm14186540","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T13:03:02Z","timestamp":1758114182000},"page":"6540","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Is Less More? Limited Surgery Is Insufficient in the Treatment of Spinal Hydatid Cysts"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8423-4266","authenticated-orcid":false,"given":"Mustafa Emre","family":"Sarac","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Adana City Traininig and Research Hospital, Adana 01230, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeki","family":"Boga","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Adana City Traininig and Research Hospital, Adana 01230, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Semih Kivanc","family":"Olguner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Adana City Traininig and Research Hospital, Adana 01230, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Arslan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Adana City Traininig and Research Hospital, Adana 01230, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1497-7069","authenticated-orcid":false,"given":"Ahmet Hamit","family":"\u00c7\u0131nk\u0131","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Adana City Traininig and Research Hospital, Adana 01230, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6709-5075","authenticated-orcid":false,"given":"Mehmet","family":"Ozer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Adana City Traininig and Research Hospital, Adana 01230, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yurdal","family":"Gezercan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Adana City Traininig and Research Hospital, Adana 01230, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Mijiti, W., Wang, X., Jia, Q., Li, Y., Zhou, Z., Reheman, T., Ayiheng, Y., Dong, S., and Xie, Z. (2024). Challenges and pitfalls in managing lumbosacral hydatid disease: Lessons learned from clinical practice. Diagn. Microbiol. Infect. Dis., 110.","DOI":"10.1016\/j.diagmicrobio.2024.116542"},{"key":"ref_2","first-page":"e4178","article-title":"Presentation Patterns, Diagnostic Modalities, Management Strategies, and Clinical Outcomes in Patients with Hydatid Disease of the Pelvic Bone: A Comparative Review of 31 Cases","volume":"11","author":"Inayat","year":"2019","journal-title":"Cureus"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1302\/2058-5241.6.200130","article-title":"Echinococcosis of the spine: A comprehensive review","volume":"6","author":"Sioutis","year":"2021","journal-title":"EFORT Open Rev."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Meng, Y., Ren, Q., Xiao, J., Sun, H., Huang, Y., Liu, Y., Wang, S., and Wang, S. (2023). Progress of research on the diagnosis and treatment of bone cystic echinococcosis. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1273870"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"529","DOI":"10.4103\/0019-5413.139886","article-title":"Hydatid disease of spine: Multiple meticulous surgeries and a long term followup","volume":"48","author":"Jain","year":"2014","journal-title":"Indian J. Orthop."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.wneu.2017.09.015","article-title":"Spinal Hydatid Cyst Disease","volume":"108","author":"Gezercan","year":"2017","journal-title":"World Neurosurg."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Neumayr, A., Tamarozzi, F., Goblirsch, S., Blum, J., and Brunetti, E. (2013). Spinal cystic echinococcosis\u2014A systematic analysis and review of the literature: Part 1. Epidemiology and anatomy. PLoS Negl. Trop. Dis., 7.","DOI":"10.1371\/journal.pntd.0002450"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1148\/radiology.140.3.7280247","article-title":"Vertebral hydatid disease: Radiological assessment","volume":"140","author":"Braithwaite","year":"1981","journal-title":"Radiology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1136\/pgmj.2007.057166","article-title":"Bone hydatid disease","volume":"83","author":"Song","year":"2007","journal-title":"Postgrad. Med. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1038\/sj.sc.3101214","article-title":"Spinal hydatid disease","volume":"40","author":"Pamir","year":"2002","journal-title":"Spinal Cord"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2439","DOI":"10.1097\/01.brs.0000184688.68552.90","article-title":"Spinal hydatidosis","volume":"30","author":"Herrera","year":"2005","journal-title":"Spine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.actatropica.2009.11.001","article-title":"Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans","volume":"114","author":"Brunetti","year":"2010","journal-title":"Acta Trop."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.ijid.2019.09.024","article-title":"Treatment experiences of thoracic spinal hydatidosis: A single-center case-series study","volume":"89","author":"Liang","year":"2019","journal-title":"Int. J. Infect. Dis."},{"key":"ref_14","first-page":"78","article-title":"Long-term disseminated recurrence in spinal hydatid cyst: A case report","volume":"24","author":"Somay","year":"2014","journal-title":"Turk. Neurosurg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jocn.2016.01.013","article-title":"Bilateral versus unilateral instrumentation in spinal surgery: Systematic review and trial sequential analysis of prospective studies","volume":"30","author":"Phan","year":"2016","journal-title":"J. Clin. Neurosci."},{"key":"ref_16","first-page":"620","article-title":"Spinal hydatid disease: A multidisciplinary pathology","volume":"80","author":"Kaloostian","year":"2014","journal-title":"World Neurosurg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3340\/jkns.2017.0245","article-title":"Spinal hydatid cyst disease: Challenging surgery\u2014An institutional experience","volume":"62","author":"Caglar","year":"2019","journal-title":"J. Korean Neurosurg. Soc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"96","DOI":"10.4103\/sni.sni_89_18","article-title":"A new surgical technique for the removal of extensive spinal epidural hydatid cyst","volume":"9","author":"Akhaddar","year":"2018","journal-title":"Surg. Neurol. Int."},{"key":"ref_19","first-page":"57","article-title":"Hydatid cyst of the spine: A rare case report and review of literature","volume":"10","author":"Sharma","year":"2020","journal-title":"J. Orthop. Case Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"353","DOI":"10.21037\/jss-22-27","article-title":"Blood loss in total en bloc spondylectomy for primary spinal bone tumours: A comparison of estimated blood loss versus actual blood loss in a single centre over 10 years","volume":"8","author":"Smith","year":"2022","journal-title":"J. Spine Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"409","DOI":"10.21037\/jss-22-87","article-title":"Blood loss after total en bloc spondylectomy","volume":"8","author":"Ryvlin","year":"2022","journal-title":"J. Spine Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"43","DOI":"10.17816\/2311-2905-17612","article-title":"Surgical Treatment of Chronic Infectious Cervicothoracic Spondylitis","volume":"31","author":"Naumov","year":"2025","journal-title":"Traumatol. Orthop. Russ."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"E12","DOI":"10.3171\/2018.10.FOCUS18472","article-title":"Parasitic infections of the spine: Case series and review of the literature","volume":"46","author":"Majmundar","year":"2019","journal-title":"Neurosurg. Focus"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/18\/6540\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:47:11Z","timestamp":1760035631000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/18\/6540"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,17]]},"references-count":23,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["jcm14186540"],"URL":"https:\/\/doi.org\/10.3390\/jcm14186540","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,17]]}}}