Udaipur: A 34-year-old carpenter suffering from recurrent spinal hydatid disease and facing a serious risk of paralysis has undergone a complex four- to five-hour surgery at Paras Health Udaipur, during which doctors removed approximately 200-250 hydatid daughter cysts from the lower spine and surrounding muscles.

The surgery was led by Dr. Ajit Singh, Director and Head of Neurosurgery at Paras Health Udaipur, with support from Dr. Abizar, Head of Anaesthesia, and his team.

The patient had been experiencing severe and progressively worsening back pain, along with sciatica-like pain in his left leg for nearly three months. His condition had made sitting comfortably, working and carrying out routine activities increasingly difficult.

The patient had previously undergone surgery for hydatid disease at another hospital in Ahmedabad around three years ago. The recurrence of the disease, the large number of cysts and changes in the anatomy caused by the earlier surgery made the case particularly challenging.

An MRI scan revealed approximately 200-250 cysts in and around the lower spine, with the cysts extending into the surrounding muscles and exerting significant pressure on the spinal nerves. Doctors said continued pressure could have resulted in weakness or paralysis of the legs and impaired bladder and bowel control.

Hydatid disease is caused by the Echinococcus parasite and most commonly affects the liver and lungs. Involvement of the spine is extremely rare. In this patient, extensive scarring and adhesions around the nerves from the previous surgery further increased the risk of neurological injury during the procedure.

Dr. Ajit Singh said the biggest challenge was operating in an area that had already undergone surgery, where extensive scarring and adhesions had developed around the nerves.

“Our priority was to decompress the nerves while safely removing the cysts and preventing them from rupturing or spreading. The extensive cyst burden in the spine and surrounding muscles made the risk of neurological injury particularly high,” he said.

The surgical team used a microscope and continuous nerve monitoring to carefully separate and remove the cysts while protecting the surrounding nerves. The surgical area was subsequently thoroughly irrigated with saline to remove any concealed or residual cyst material.

Doctors took special precautions to prevent the cysts from rupturing, as exposure to their contents can trigger anaphylaxis, a severe allergic reaction. The anaesthesia team remained prepared to manage any such emergency during the procedure.

The patient's leg pain subsided immediately after surgery. He was able to walk the following day and was discharged from the hospital after two days.

Recalling his experience, the patient said that worsening pain had gradually made it difficult for him to sit, work and carry out his daily activities. Since he had undergone surgery for the same condition previously, the recurrence of symptoms had caused considerable concern. He said the immediate relief after surgery and ability to walk the next day had brought him significant relief and given him hope of returning to his normal routine.

Doctors have advised the patient to remain under long-term follow-up, as spinal hydatid disease can recur even after surgery. Regular monitoring will be important to assess his recovery and detect any possible recurrence at an early stage.