Anterior endoscopic treatment of a huge anterior sacral meningocele: technical case report.

Abstract

Anterior endoscopic treatment of a huge anterior sacral meningocele, a rare example of spinal dysraphism, is described. A 43-year-old woman presented with severe headache and fever, increasing abdominal pain, and a several-year history of right lower-extremity radicular pain. She exhibited meningeal irritation signs and Currarino's triad. Lumbosacral myelograms and magnetic resonance imaging scans revealed a huge anterior sacral cyst connected with the spinal subarachnoid space. A straight rigid endoscope was introduced into the meningocele through a small abdominal incision. The fistula between the meningocele and the spinal subarachnoid space was obliterated with multiple fat grafts harvested from the abdomen. An anterior endoscopic procedure is an alternative for the treatment of a huge anterior sacral meningocele.