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骶骨前脊膜膨出(Anterior sacral meningoceles)是一种少见的脊柱裂畸形。它由骶骨前壁骨质缺损的膜囊疝出形成。本文报告一例继发于椎管内皮样肿物的无菌性脊膜炎反复发作形成的骶骨前脊膜膨出。患者21岁,女性,4年前曾尾骨脊膜膨出而行后入路手术,因神经内容物进入膨出的囊内手术未成功。这次入院前3周突感剧烈头痛、发烧、下肢无力,伴脑膜刺激症。CSF:白细胞数2810/cumm,细菌培养阴性。4天后症状控制。检查:骶部感觉存在,直肠后有一大的固定肿块。骶部平片和体层造影示骶2～4右侧有一较大镰状骨缺损。钡灌肠示乙状结肠向右推移。静脉肾盂造影输尿管向外移位。甲泛影酰胺(Metrizamide)脊髓腔造影确定脊膜囊与骶骨前肿块相连。同时行腹部和腰骶部CT扫描显示盆腔肿块经前部骶骨缺损与脊膜囊相通。手术方法:作经骶骨后入路,将腰4～骶1椎板咬除,沿尾骨中线分离出缺损处,暴露骶管内大的固定肿块。切开硬膜后发现终丝附着椎管内皮样肿物
Anterior sacral meningoceles are a rare form of spina bifida. It is formed by the membranous hernia of the sacral anterior osseous defect. This article reports a case of anterior sacral anterior sacral membrane that recurrently forms of aseptic meningitis secondary to endothelium-like tumors in the spinal canal. The patient, 21 years old, was a female. Four years ago, the caudal spine had bulged and posterior approach surgery, resulting in an unsuccessful neurosurgical invasion of the bulging cyst. 3 weeks before the admission sudden severe headache, fever, weakness in the lower extremities, with meningeal irritation. CSF: WBC number 2810 / cumm, bacterial culture negative. Symptom control after 4 days. Check: sacral sensory existence, there is a large fixed rectum lumps. Sacral plain film and tachycardia showed sacral 2 ~ 4 on the right side of a larger sickle defect. Barium enema sigmoid colon to the right shift. Intravenous pyelography ureter outward displacement. Metrizamide Spinal cavity imaging confirmed attachment of the dural sac to the anterior sacral mass. At the same time the abdomen and lumbosacral CT scan showed pelvic mass by the anterior sacral defect and the spine sac connected. Surgical methods: for the sacral approach, the lumbar 4 ~ sacral 1 lamina bite removed along the coccyx midline to isolate the defect Department, exposing large fixed sacral mass. Cut the dura after the discovery of the terminal wire attached to the endothelium-like tumor