Resection of a giant anterior sacral meningocele via an anterior approach: case report and review of literature.
BACKGROUND
An anterior sacral meningocele is a rare form of spinal dysraphism that is sometimes associated with syndromes such as Currarino and Marfan syndromes. These lesions rarely cause neurological complications, but meningitis, sepsis, obstetric problems, and bowel and bladder difficulties are common secondary conditions. The lesions can even be fatal. Because these lesions usually do not regress spontaneously, surgical treatment is the standard for symptomatic or growing masses. The dural defect can be repaired with a variety of anterior or posterior approaches.


METHODS
We present a case of a 16-year-old female patient with a giant nonsyndromic anterior sacral meningocele that we successfully treated using an open anterior approach. We discuss the treatment options and present a brief review of the literature.


CONCLUSIONS
Although the posterior approach remains the treatment of choice for most lesions, we believe that the anterior laparotomy provides excellent exposure and is a safe alternative approach for the treatment of selected lesions. Patients with these lesions should be cared for by a multidisciplinary team.
Ashley
William W
WW
Department of Neurosurgery, Washington University School of Medicine, Saint Louis, MO 63110, USA.
Wright
Neill M
NM
D000293:Adolescent; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control; D019299:Decompression, Surgical / Q000379:methods; D004388:Dura Mater / Q000473:pathology / Q000601:surgery; D005260:Female; D006261:Headache / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008588:Meningocele / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D010388:Pelvis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011859:Radiography; D012447:Sacrum / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D016135:Spinal Dysraphism / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014599:Uterus / Q000002:abnormalities