Surgical management of anterior sacral meningoceles: an illustrated case series and review of the literature.

Autor:	Kamal MA; Department of Neurosurgery, Royal Victoria Hospital, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK., Eltayeb M; Department of Neurosurgery, Royal Victoria Hospital, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK., Coulter I; Department of Neurosurgery, Royal Victoria Hospital, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK., Jenkins A; Department of Neurosurgery, Royal Victoria Hospital, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK.
Jazyk:	angličtina
Zdroj:	British journal of neurosurgery [Br J Neurosurg] 2024 Dec; Vol. 38 (6), pp. 1374-1380. Date of Electronic Publication: 2023 Jan 03.
DOI:	10.1080/02688697.2022.2162852
Abstrakt:	Background: Anterior sacral meningocele (ASM) is an uncommon variant of spinal dysraphism. Surgical correction for this condition is challenging and optimal corrective approaches are uncertain. Objective: To share our experience of managing this rare condition using the posterior trans-sacral approach and provide a contemporary review of the literature. Methods: Retrospective review of case notes, operative records, and imaging of eligible patients treated via the posterior trans-sacral approach between 2006 and 2020 at our regional neurosciences centre. Results: Three patients, two females and one male with a mean age of 30 years (range 16-38), were treated. Presenting symptoms included lower abdominal pain and recurrent miscarriages. Patients underwent corrective surgery using the posterior approach involving a sacral laminectomy, durotomy and closure of the communicating fistula. A single patient required reoperation due to early recurrence. Another patient proved challenging because of a very large sacral fistula and required two procedures due to the development of high-pressure headaches secondary to a recurrence. All patients improved symptomatically postoperatively and remained symptom free at the last clinic follow-up and have been discharged. Following review of the literature, only two other non-syndromic cases have been described. Conclusions: ASM is an uncommon congenital abnormality, typically presenting with mass effect symptoms secondary to a presacral cystic mass. Surgical management using a posterior approach to close the meningeal sac is feasible and less invasive than an anterior approach. Long term clinical outcomes in our series were satisfactory.
Databáze:	MEDLINE
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