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Due to these symptoms and the presence of a growing mass a new surgical procedure consisting in a posterior sacral laminectomy and ligation of the meningocele cyst was proposed. The patient was very unkeen in further surgery, particularly after the results of the previous ones, however, she was so ill that she accepted surgery.   The procedure was performed in a prone position, a sacral laminectomy was executed, the dura was so thin that it kept tearing continuously, after complete dural exposure the anterior sacral defect lean out, subsequently to ligation of the neck, both an anterior and posterior dural patch was placed in order to prevent further leaks of CSF, a left drainage was placed. The patient remained in bed rest for about 5 days, with further improvement of the symptomatology, she remained hospitalized for 7 days and was discharged without any complications.At 3 months post surgery an MRI (Figure 2.) was made, revealing complete remission of the anterior sacral meningocele. Although the abdomino-pelvic symptoms disappear, the sciatic and lumbar pain remained with lower intensity.