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

Objective And Importance: Anterior endoscopic treatment of a huge anterior sacral meningocele, a rare example of spinal dysraphism, is described.

Clinical Presentation: 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.

Intervention: 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.

Conclusion: An anterior endoscopic procedure is an alternative for the treatment of a huge anterior sacral meningocele.