Abstract
Comparison of some cases in adults to an extensive malformation in the small pelvis
in a 4 years old girl.
Sacral ventral meningoceles are rare spinal malformations which probably result from
a dysrhaphic disorder in an early embryonal stage (spina bifida). The dysrhaphic malformation
extends towards the os sacrum with a defect in ventral direction.
In this paper, we present the cases of one child and three adults. The malformative
tumor in the small pelvis of the child was so large that an obstruction of the urinary
tract and of the rectum resulted. In addition to this there was a paralysis of the
peroneal muscles caused by a congenital defect in the nervous system. The large space
occupying tumor in the small pelvis was surgically reduced and separated from the
subarachnoid space, after which considerable postoperative improvement was observed.
In the cases of the three adults, suffering from lumbal ischialgy, similar but much
smaller malformations had been discovered through myelography. Two of these patients
improved after removal of degenerated discs, and one by conservative treatment. There
was no relation between the neurologic symptoms and the small ventral meningoceles.
A surgical removal of sacral ventral meningoceles is indicated, when these appear
as space occupying tumors in the small pelvis. The tumor can then be reached from
the CSF-space in order to relieve the obstruction of the urinary tract and the rectum.
Zusammenfassung
Es werden vier Fälle mit sakralen ventralen Meningozelen dargestellt: Bei einem Kinde
ergab sich eine sichere Operationsindikation: Es lag eine große raumfordernde liquorgefüllte
Mißbildung im kleinen Becken vor. Sie wurde verkleinert und vom Liquorraum getrennt,
wonach sich die klinischen Symptome erheblich besserten. In den drei übrigen Fällen
hat es sich um zufällig entdeckte ähnliche, aber erheblich kleinere (nicht im Becken
raumfordernde) Mißbildungen gehandelt. Diese drei Patienten wurden wegen einer Bandscheibenerkrankung
in zwei Fällen operativ und in einem Fall konservativ behandelt, wonach weitgehende
Besserung eintrat. Zur Operationsindikation bei solchen Mißbildungen wird Stellung
genommen.
Keyword
Sacral ventral meningocele - spinal malformation - spina bifida
