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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, however we proceed continuously. We proceeded  with the dissection intraduraly  in order to achieve the greatest possible exposure of the defect, after anterior sacral defect. After  complete dural intradural  exposure the anterior sacral defect lean out, subsequently we pursue 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, both neck. The intradural procedure ended by placing  an anterior and posterior dural patchwas placed  in order to prevent further leaks of CSF. CSF fitula. A lumbar drain was placed for similar reasons.  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. After A  3 months post surgeryan  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.