Study Design. This case report illustrates a young male patient with t
horacal spinal pigmented villonodular synovitis who presented with dif
ficulty in walking. Objectives. The treatment of this lesion with post
erior approach for preventing neurological deterioration and follow-up
with magnetic resonance imaging studies. Summary of Background Data.
Spinal involvement of pigmented villonodular synovitis rare. It is tre
ated by radical surgical excision. But in some cases, as in our case,
surgical total excision of the lesion with a one-stage operation is no
t possible. For this reason, in such cases, follow-up studies with mag
netic resonance images are sufficient. This report represents the 14th
case of spinal involvement of pigmented villonodular synovitis. Metho
ds. The patient presented with difficulty walking and received surgery
including posterior decompression and subtotal tumor excision. All ne
urologic signs and symptoms disappeared in a short period. Postoperati
vely, follow-up studies with magnetic resonance imaging were performed
and regrowth of residual lesion was not detected. Results. The patien
t was discharged home without neurologic deficit. Follow-up studies wi
th magnetic resonance images showed no regrowth of residual lesion.Con
clusions. The principle of surgical management of spinal lesions causi
ng neurologic deficit is early surgical decompression. Although pigmen
ted villonodular synovitis requires total excision, in the presented c
ase total excision of lesion was impossible, because vertebral body in
volvement needs an anterior or posterolateral approach. During the 16-
month follow up, regrowth of the lesion has not occurred. These observ
ations indicate that surgical decompression and follow-up of a patient
with magnetic resonance imaging constitute a satisfactory treatment o
f pigmented villonodular synovitis.