Surgical management in spinal sarcoidosis: case report.

STUDY DESIGN

Case report of a patient with transient paraplegia and spine instability because of sarcoidosis of 2 vertebral bodies.

OBJECTIVES

To report a rare case of vertebral sarcoidosis accompanied by transient neurologic symptoms and spine instability, and to discuss the diagnostic and therapeutic management.

SUMMARY OF BACKGROUND DATA

Vertebral sarcoidosis is a rare condition, and only a few case reports exist in the literature. In most cases, treatment with steroids improves associated neurologic symptoms. Operative intervention is necessary in cases with spinal instability because of progressive vertebral destruction and impending or progressive neurologic deterioration.

METHODS

After steroids therapy and subsequent neurologic improvement, operative treatment by a 2-stage posterior stabilization followed by anterior vertebrectomy and fusion was given to a patient with 2-level vertebral sarcoidosis and residual spine instability.

RESULTS

After steroids therapy, the patient had a complete neurologic recovery; satisfactory spinal stability was achieved after surgery.

CONCLUSION

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. Steroids therapy provided neurologic improvement, posterior stabilization combined with anterior vertebrectomy and fusion provided spine stability for the patient in this report.