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The procedure was performed in a prone position, a sacral laminectomy was executed, after exposure of the dural sac, we note that the dura was so thin that it kept tearing continuously. We proceeded with the dissection intraduraly in order to achieve the greatest possible exposure of the anterior sacral defect. After complete intradural exposure the anterior sacral defect lean out, subsequently we introduce the suction into the defect, once we were certain that there was no nerve root on it, the suction pressure allowed us to pull up the anterior wall of the pseudomeningocele and then we pursued with the ligation of the neck. The intradural procedure ended by placing an anterior and posterior dural patch in order to prevent CSF fitula. A lumbar drain was placed for similar reasons.  The patient was kept remained  inflat  bed rest for about  5 days, the lumbar drain remain open for 2 days and removed. days.  She was mobilized on day 5 3  and noted to have be  full strength on motor examination. No examination, with no  bowel or bladder disturbances were detected. Following problems. With  further improvement of the symptomatology,  she remained hospitalized for 7 days and was discharged with no without any  complications. A 3 months post surgery MRI (Figure \ref{fig:FIGURE_2}) was made, revealing complete closure of the ASM anterior sacral meningocele  with no compression on of the  pelvic structures. Although the abdomino-pelvic symptoms disappear, the lumbar pain remained with lower intensity probably caused by the severe scoliosis that the patient had.