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The procedure Surgery  was performed in a prone position, a position. Following  sacral laminectomy was executed, after exposure of the laminectomy,  dural sac, we note that the sac was exposed. The  dura was so thin that it kept tearing continuously. We proceeded with the dissection intraduraly in order to achieve the greatest possible The dura was finally opened and  exposure of the anterior sacraldefect. After complete intradural exposure the anterior sacral  defect lean out, subsequently was achieved. Once  we introduce had control of  the ASM neck, low  suction was introduced  into the defect, once we were certain that there was no nerve root on it, the suction pressure allowed us to pull up and  the anterior wall of the pseudomeningocele and then we pursued with the was pulled up. Then  ligation of the neck. neck was performed.  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. left in place.  The patient remained in bed rest for about 5 days, the lumbar drain remain open for 2 days. She was mobilized on day 3 and noted to be full strength on motor examination, with no bowel or bladder problems. With further improvement of the symptomatology, she remained hospitalized for 7 days and was discharged without any complications. A 3 months post surgery MRI (Figure \ref{fig:FIGURE_2}) was made, revealing complete closure of the anterior sacral meningocele with no compression 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.