Costo-vertebral hydatid disease : surgical management and post-operative course

<bold>Introduction:</bold> Primary costo-vertebral hydatidosis (CVH) is an uncommon condition even in countries where echinococcosis is endemic. Curative treatement remains complete costo-vertebral resection without spillage of the cyst's content. <bold>Material and Methods:</bold> The aim of our study is to share our experience in the surgical management of patients with CVH, between 2000 and 2022. <bold>Results:</bold> Sixteen patients with CVH were operated on in our department. The mean age was 51 years old. Surgical history of hydatid cyst was found in 8 cases. The most common symptom was chest pain in 7 cases. Six patients had neurological signs. Parietal mass was observed in 6 cases. CT scann and MRI were suggestive in 15 cases. In the other case, a chest wall tumor was suspected. Our team collaborated with orthopedists and all of our patients underwent costo-vertebral resection. A rib resection was performed for all of our patients, it was associated with vertebral body resection in 7 cases, with transverse process resection in 5 cases, and with both in 4 cases. None of our patients had chest wall defect reconstruction. Five patients had postoperative complications: paraplegia (1 case), hemiplegia (1 case) and surgical site infection (3 cases). One patient died on the 12th postoperative day after an acute respiratory distress syndrome. Postoperative course was uneventful for the other patients. Reccurence was found in 5 cases after long term follow-up. <bold>Conclusion:</bold> CVH is a rarely reported in literature and its management remains not codified. Radical resection remains the treatment of choice to avoid reccurence. It consists on cutting the invaded vertebral body and rib in healthy margins without rupture of the cyst.