Surgical management for instability and paraplegia caused by spinal sarcoidosis. A case report.
METHODS
Report of a patient with paraplegia caused by vertebral sarcoidosis.


OBJECTIVE
To report a rare case of vertebral sarcoidosis accompanied by progressive neurologic symptoms from the lower extremities, and to discuss the diagnostic and therapeutic approach to its management.


BACKGROUND
Vertebral sarcoidosis is a rare condition, and only a few case reports exist in the literature. A needle or open biopsy is required to establish the diagnosis. In most cases, treatment with steroids improves associated neurologic symptoms. Operative intervention is necessary in cases with progressive vertebral destruction, spinal instability, and impending or progressive neurologic deterioration.


METHODS
Operative treatment by a two-stage anterior vertebrectomy and fusion followed by posterior stabilization was given to a patient with vertebral sarcoidosis and progressive neurologic deterioration of the lower extremities.


RESULTS
After surgery, the patient had a complete neurologic recovery and satisfactory spinal fusion.


CONCLUSIONS
In the absence of any spinal instability, neurologic symptoms associated with vertebral sarcoidosis respond satisfactorily to nonoperative treatment with steroids. Progressive neurologic deterioration or spinal instability caused by bone destruction requires operative intervention. Anterior vertebrectomy and fusion combined with posterior stabilization provided a satisfactory result for the patient in this report.
Tzagarakis
G P
GP
Orthopaedic Department, Athens University Medical School, General Hospital KAT, Greece.
Papagelopoulos
P J
PJ
Sapkas
G S
GS
Tsarouchas
J K
JK
D000368:Aged; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D010264:Paraplegia / Q000209:etiology* / Q000601:surgery; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013122:Spinal Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013123:Spinal Fusion