SURGICAL-MANAGEMENT FOR INSTABILITY AND PARAPLEGIA CAUSED BY SPINAL SARCOIDOSIS - A CASE-REPORT

Study Design. Report of a patient with paraplegia caused by vertebral sarcoidosis. Objectives. To report a rare case of vertebral sarcoidosi s accompanied by progressive neurologic symptoms from the lower extrem ities, and to discuss the diagnostic and therapeutic approach to its m anagement. Summary of Background Data. Vertebral sarcoidosis is a rare condition, and only a few case reports exist in the literature, A nee dle or open biopsy is required to establish the diagnosis. In most cas es, treatment with steroids improves associated neurologic symptoms. O perative intervention is necessary in cases with progressive vertebral destruction, spinal instability, and impending or progressive neurolo gic deterioration. Methods. Operative treatment by a two-stage anterio r vertebrectomy and fusion followed by posterior stabilization was giv en to a patient with vertebral sarcoidosis and progressive neurologic deterioration of the lower extremities. Results, After surgery, the pa tient had a complete neurologic recovery and satisfactory spinal fusio n. Conclusions. In the absence of any spinal instability, neurologic s ymptoms associated with vertebral sarcoidosis respond satisfactorily t o nonoperative treatment with steroids. Progressive neurologic deterio ration or spinal instability caused by bone destruction requires opera tive intervention. Anterior vertebrectomy and fusion combined with pos terior stabilization provided a satisfactory result for the patient in this report.