Anterior sacral meningocele with S1 root incarceration: Marfan syndrome and its surgical management. Illustrative case.

BACKGROUND

Anterior sacral meningocele (ASM) is a rare form of spinal dysraphism in children. Operative management, either an anterior or posterior approach, has been widely used by surgeons. This single-case study aims to present the surgical management and outcomes of a 22-year-old woman with multiple ASMs.

OBSERVATIONS: A 22-year-old woman with Marfan syndrome had been followed up for her scoliosis. Occasional numbness of the left lateral thigh and leg was noted. Intermittent progressive pain and paresthesia were noted in the low back, left lateral thigh, and sole. Spine MRI showed dural ectasia with pedicle thinning in the lumbosacral region as well as multiple meningoceles in the sacral and pelvic regions, with the largest being about 8 × 9 cm in size. Surgery was performed with a single posterior approach. The herniated nerve roots were preserved and pushed back into the thecal sac, and the meningocele was obliterated. Follow-up MRI performed 4 months later showed shrinkage of the large meningocele.

LESSONS: This case demonstrated the surgical management and acceptable outcomes of a large ASM. https://thejns.org/doi/10.3171/CASE26306.