title: Late paraplegia after scoliosis treatment: an uncommon diagnosis.
abstract: We report the case of a young girl treated at age 16 for a progressive scoliosis by posterior instrumented arthrodesis. Ten years later, she suddenly developed lumbar pain and paraplegia. The surgical procedure showed a mass infiltrating the vertebral canal and the dural sheath following a supralaminar hook. Histology revealed a diagnosis of leiomyosarcoma. The outcome was poor with a rapid and fatal extension of the tumor. There is nothing to justify a causal link between the scoliosis and the late onset of a malignant tumor. Nevertheless, we discuss the potential role of diagnostic irradiation consecutive to scoliosis monitoring during growth and the potential role of environmental carcinogens like metallic biomaterials. Finally, rapid intrusion of this extraspinal tumor into the dural sheath resulted in a confusing clinical picture and delayed the diagnosis and treatment of the tumor.
authors.affiliation: Service de chirurgie orthopédique et traumatologique, Fondation Hôpital Saint Joseph, Paris, France. ravialle@noos.fr
authors.forename: Raphaël
authors.initials: R
authors.lastname: Vialle
authors.forename: Stéphane
authors.initials: S
authors.lastname: Wolff
authors.forename: Philippe
authors.initials: P
authors.lastname: David
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Lepeintre
authors.forename: Patrick
authors.initials: P
authors.lastname: Hautefort
authors.forename: Marc
authors.initials: M
authors.lastname: Tadie
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis* / Q000209:etiology; D010264:Paraplegia / Q000175:diagnosis* / Q000209:etiology*; D012600:Scoliosis / Q000150:complications* / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects*; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000209:etiology