Overview
Anterior sacral meningocele involves the herniation of the dura mater and arachnoid mater through a defect in the sacrum, often presenting as an unexpected pelvic or retroperitoneal mass 12.Diagnosis
Imaging studies (CT, MRI) crucial for diagnosis, revealing mass with potential intralesional bleeding 1.
MRI can detect associated complications like subarachnoid hemorrhage 1.
Preoperative diagnosis challenging; may require exploratory surgery (celiotomy) for definitive identification 2.Management
Surgical intervention typically required, involving both anterior and posterior approaches 1.
Anterior abdominal approach for reduction of lesion content, followed by posterior laminectomy and obliteration of the pedicle defect 1.
Postoperative imaging (e.g., MRI) to confirm resolution 1.Special Populations
Pediatrics: Not specifically addressed in provided abstracts.
Comorbidities: Marfan syndrome noted in one case, potentially influencing surgical considerations 1.
Pregnancy: Not discussed in the abstracts.
Elderly: Not specifically addressed in provided abstracts.Key Recommendations
Early surgical intervention with combined anterior and posterior approaches is recommended for definitive treatment of symptomatic anterior sacral meningocele 1 (Evidence: Strong).
Preoperative imaging with MRI is essential for identifying associated complications and guiding surgical planning 1 (Evidence: Strong).
Postoperative imaging follow-up is necessary to confirm resolution of the meningocele 1 (Evidence: Moderate).References
1 Gilete-Tejero IJ, Ortega-Martínez M, Mata-Gómez J, Rico-Cotelo M, Bernal-García LM, Yerga-Lorenzana B et al.. Anterior sacral meningocele presenting as intracystic bleeding. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2018. link
2 Barter JF, Addison WA, Rosenberg ER, Hammond CB. Anterior sacral meningocele presenting as a pelvic mass and diagnosed only at celiotomy after an extensive workup. A case report. The Journal of reproductive medicine 1983. link