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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 We believe that this approach was appropriate in order to get a correct exposure of the cyst neck. Initially, 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, after exposure of the dural sac, we note that  the dura was so thin that it kept tearing continuously, however we proceed with the dissection in order to achieve the greatest possible exposure of the defect,  after complete dural exposure the anterior sacral defect lean out, subsequently to we pursue with the  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. CSF.