: Hydatid Cyst is a protozoal disease, whose spinal localization may be cause of pain and severe inability due to neurological symptoms and instability. Treatment combines the difficulties to eradicate the cyst with the spine regional constraints. The case of a 45-year-old woman is reported, affected by hydatid cyst in the spine, submitted to combination of medical treatment and surgery (double approach gross total excision and reconstruction) and followed up for 6 years. The treatment strategy allowed an excellent quality of life without pain and neurological symptoms at the latest follow-up. This case supports the validity to combine anthelmintic medical treatment and excisional surgery in the treatment of hydatid cyst of the spine. The medical treatment makes surgery more effective maintaining the result over long term. Subtotal or total excision of the cysts can be performed, including decompression of neural structures and adequate spine reconstruction.
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