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Giant anterior sacral meningocele and posterior sagittal approach

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Abstract

Object

Anterior sacral meningocele (ASM) is a rare congenital malformation. Often while still asymptomatic, ASM may achieve a considerably size, to the extent of exerting a mass effect on the pelvic structures. Spontaneous rupture with subsequent septic meningitis is the most frequent and dangerous complication. The meningocelic sac is usually isolated by a surgical procedure that requires a sacral laminectomy or a transabdominal approach. Recently an alternative surgical technique, the posterior sagittal approach, has been proposed.

Methods

We report on a 15-year-old girl with a long clinical history of constipation and sporadic cystitis. Radiological examinations showed progressive enlargement of a presacral lipomeningocele, which grew to 12×14 cm. A posterior sagittal approach was performed; the stalk was ligated, the sac totally excised and a small associated tumour removed. No intra-/post-operative complications were observed.

Conclusion

The posterior sagittal approach is an easy and safe surgical technique for the treatment of ASM, as it allows a complete isolation of the lesion and the removal of associated tumors without significant morbidity.

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Authors and Affiliations

  1. Paediatric Neurosurgery, Catholic University of Medical School, Largo A. Gemelli 8, 00168, Rome, Italy

    Luca Massimi & Concezio Di Rocco

  2. Department of Paediatric Surgery, S. Camillo Hospital, Via G. Ferrari 11, 00195 , Rome, Italy

    Alessandro Calisti

  3. Division of Neurosurgery, “Agia Sophia” Children’s Hospital, 11527, Goudi, Athens, Greece

    Michalis Koutzoglou

Authors
  1. Luca Massimi
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  2. Alessandro Calisti
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  3. Michalis Koutzoglou
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  4. Concezio Di Rocco
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Correspondence to Luca Massimi.

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Massimi, L., Calisti, A., Koutzoglou, M. et al. Giant anterior sacral meningocele and posterior sagittal approach. Childs Nerv Syst 19, 722–728 (2003). https://doi.org/10.1007/s00381-003-0814-1

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  • DOI: https://doi.org/10.1007/s00381-003-0814-1

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