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The anterior transabdominal approach could be performed via laparoscopic or open trans-abdominal/laparotomy, usually it is not considered as the first option unless decompression and rapid removal of the cyst wall is required. Extreme caution must be taken when extensive resection of the cyst wall is performed since adherence to surrounding visceral structures can lead to complications such as fecal or vesical fistulas.\cite{16793455}  Several reports have stressed the advantages of the posterior transsacral technique, since there it  is usually no need to decompress or remove the cyst. Instead, treatment via considered as  a posterior relatively easy and safe technique and is weighted by only a low septic risk. This  approach allows  to interrupt perform gently ligation of  the fistula is sufficient, and stalk of  the cyst will gradually and spontaneously resolve(citas). malformation without the need for other advantages obtained with this approach are preservation of the integrity of the nerve roots, spinal cord detethering and, if necessary, reconstruction of any dural defect by microsurgical techniques.