Surgical treatment of congenital anterior sacral meningomyelocele

Abstract

Objective To investigate the clinical characteristics and surgical treatment method of congenital anterior sacral meningomyelocele in order to reduce surgical complications and improve prognosis by selecting the appropriate surgical approaches and surgical methods. Methods The clinical data of 4 patients with congenital anterior sacral meningomyelocele treated at the Department of Neurosurgery, Chinese PLA General Hospital from February 2014 to April 2015 were analyzed retrospectively. The clinical manifestations included abdominal pain, numbness of limbs, constipation, urinary urgency, urinary frequency, and other symptoms. The follow-up time ranged from 2 to 12 months (mean 6.5 months). Results The postoperative symptoms of the 4 patients had different degrees of improvement compare with the before procedure. The MRI reexamination revealed that the anterior sacral meningocele disappeared. No postoperative cerebrospinal fluid leakage, peritoneal effusion, wound infection, and other complications were found. Conclusions The clinical manifestation of congenital anterior sacral meningocele is mainly pelvic organ compression symptom. Microsurgical operation via posterior median approach can achieve good effect. Properly treating fistula and protecting sacral nerve during the operation may avoid the occurrence of postoperative cerebrospinal fluid leakage after procedure. Key words: Neural tube defects; Meningomyelocele; Microsurgery