Patients with
neurosarcoidosis are usually initially treated with
steroid administration even when they have concomitant cord compression on magnetic resonance imaging (MRI). Operative intervention may be indicated in patients with spinal cord
sarcoidosis requiring either tissue biopsy for diagnosis or associated with progressive
neurologic symptoms. However, there have been no previous reports describing clinical outcomes of
laminoplasty for spinal cord
sarcoidosis. The objectives of this study are to investigate whether extensive cervical
laminoplasty is an effective treatment for spinal cord
sarcoidosis combined with spondylotic changes and/or cervical spinal canal
stenosis. Open-door
laminoplasty was performed in three patients with spinal cord
sarcoidosis. All patients received intensive
corticosteroid therapy after the operation MRI imaging was performed in all patients before and after the operation. Operative outcomes were not satisfactory and the clinical courses of the patients fluctuated after
corticosteroid therapy. Daily life activities were not significantly improved
after treatments in any of the three patients, and in the long-term follow-up period the
clinical course of one patient was one of inexorable deterioration to a state of
quadriplegia. The possibility of spinal cord
sarcoidosis should be included in the differential diagnosis, when a distinct high signal intensity area is observed within the spinal cord on T2-weighted MR images in patients with spondylotic changes.
Laminoplasty is not an effective intervention for the treatment of spinal cord
sarcoidosis even when patients have spondylotic changes and/or a constitutionally narrowing cervical spinal canal. Patients with
neurosarcoidosis should be treated first with
steroid administration even when they have concomitant cord compression on MRI.