Tethered Cord Syndromeを合併したAnterior Sacral Syndromeの1症例

Anterior Sacral Meningocele Associated with Tethered Cord Syndrome

I．はじめに

　anterior sacral meningoceleは仙骨前壁の椎体欠損部より先天的にdural sacが前方に突出し骨盤腔内に腫瘤を形成して発見されることの多い疾患であるが，われわれはtethered cord syndromeを呈したanterior sacral meningoceleの稀な1例を経験したので報告する．

A case of anterior sacral meningocele associated with tethered cord syndrome is reported.

A 5-year-old boy was admitted for urinary and fecal incontinence which had persisted since his birth. Abdo-minal MRI and sacral CT showed a presacral cystic mass communicating with the spinal dural sac through a neck traversing a sacral bony defect and tethered spinal conus. Neurological examination showed that the patient had a neurogenic bladder, atrophy of the legs and anesthesia below the S3 level. Operative finding revealed a thick-ened filum terminale attached to the wall of the presacralmeningocele. Agenesis of the nerve root below the S, level was identified, and no neural elements entered into the sac. Untethering was performed. Postoperative course was uneventful and the patient is doing well with his neurogenic bladder gradually improving.