Role of screening of whole spine with sagittal MRI with MR myelography in early detection and management of occult intrasacral meningocele
A thirty-year-old male presented with weakness in upper limbs, cervical pain, and mild fever. Whole-spine sagittal T2-weighted MRI showed mild spondylosis in the cervical region. However, an intrasacral cyst measuring approximately 3.8×3.7×1.8 cm was observed. On further detailed imaging, lumbarization of the S1 vertebra was seen with a low-lying conus medullaris terminating at L3-L4 level. In addition, a thickened fatty filum terminale was detected which was adherent to the intrasacral cyst at the S3-S4 level. The cyst had a small communication with the distal end of the thecal sac leading to a diagnosis of occult intrasacral meningocele [Figure –]. Laminectomy was done along with excision of the cyst and a part of thickened filum terminale. Histopathological examination showed the cyst wall to be formed by nonspecific fibrous tissue lining. The patient showed an uneventful postoperative course and good outcome with only mild pain during follow-up at one year.