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Updated: Jun 25, 2026

Intraoperative Ultrasound in Spinal Surgery
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Neurosarcoidosis Masquerading as Spinal Stenosis.

Ameen Batheesh1, Nina Borissovsky2, Devy Zisman1,3

  • 1Rheumatology Unit, Carmel Medical Center, Haifa 3436212, Israel.

Diagnostics (Basel, Switzerland)
|October 25, 2024
PubMed
Summary

This case study highlights rare intramedullary spinal neurosarcoidosis mimicking spondylotic myelopathy. Prompt diagnosis and treatment with immunosuppressants led to significant clinical and radiographic improvement.

Keywords:
MRImyelopathyneurosarcoidosisspinal stenosistrident sign

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Area of Science:

  • Neurology
  • Immunology
  • Radiology

Background:

  • Intramedullary spinal neurosarcoidosis is a rare condition.
  • It can present with symptoms mimicking other spinal cord diseases like spondylotic myelopathy.
  • Early diagnosis and treatment are crucial for patient outcomes.

Purpose of the Study:

  • To report a rare case of intramedullary spinal neurosarcoidosis.
  • To discuss the diagnostic challenges and treatment strategies.
  • To emphasize the importance of considering neurosarcoidosis in patients with myelopathy symptoms.

Main Methods:

  • Clinical presentation and neurological examination.
  • Spinal MRI with contrast.
  • Chest CT scan.
  • Mediastinal lymph node biopsy.
  • Exclusion of other myelopathies (demyelinating, infectious, paraneoplastic).

Main Results:

  • Patient presented with progressive pain, weakness, and urinary incontinence.
  • Spinal MRI showed cervical and lumbar spinal cord compression with enhancement.
  • Mediastinal lymph node biopsy revealed non-necrotizing granulomas.
  • Diagnosis of neurosarcoidosis and spondylotic myelopathy was established.
  • Treatment with glucocorticosteroids, azathioprine, and infliximab resulted in improvement.

Conclusions:

  • Intramedullary spinal neurosarcoidosis can mimic spondylotic myelopathy clinically and radiographically.
  • Diagnostic workup should include exclusion of other myelopathies and systemic evaluation for granulomatous disease.
  • Multimodal treatment approach is effective for managing spinal neurosarcoidosis.