Expanding occult intrasacral meningocele associated with diastematomyelia and multiple vertebral anomalies. Case report

Abstract

The authors report the case of a 7-year-old girl who presented with persistent low-back and left leg pain and was diagnosed with expanding occult intrasacral meningocele (OIM), diastematomyelia, tethered cord, and multiple vertebral anomalies. She was followed for 27 months. Removal of a bone spur and sectioning of the tight terminal filum did not relieve her left leg and back pain. Serial magnetic resonance (MR) imaging after initial detection of the OIM revealed gradual but significant enlargement of the lesion. Fifteen months after terminal filum release and bone spur resection, the OIM was excised. After this surgery, the back and leg pain resolved. No case of OIM reported to date contains documented serial MR imaging confirmation of enlargement of OIM. Furthermore, this is the first report of OIM associated with diastematomyelia. Because most OIMs expand, the authors recommend that, in addition to surgery for associated congenital anomalies, the OIM be totally excised to resolve symptoms completely.