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J Neurol Surg A Cent Eur Neurosurg 2013; 74(S 01): e104-e106
DOI: 10.1055/s-0032-1326938
Case Report
Georg Thieme Verlag KG Stuttgart · New York

An Unusual Sacral Osteomyelitis Due to an Occult Anterior Sacral Meningocele

Erdal Resit Yilmaz
1   Department of Neurosurgery, Diskapi Yildirim Beyazit Training and Research Hospital Ankara, Ankara, Turkey
,
Askin Esen Hasturk
2   Oncology Training and Research Hospital, Department of Neurosurgery, Ankara, Turkey
,
Sukru Caglar
3   Department of Neurosurgery, Ankara University Hospital, Ankara, Turkey
› Author Affiliations
Further Information

Publication History

12 January 2012

27 May 2012

Publication Date:
03 October 2012 (online)

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Abstract

Objectıve We present the extremely rare case of sacral osteomyelitis due to an anterior sacral meningocele (ASM) with fistula to the skin. We also discuss the case's clinical significance and the importance of imaging in diagnosis.

Methods A 28-year-old female patient was referred to our clinic due to back and hip pain, erythema, and purulent discharge from the right gluteal region. Neurological examination was normal except for pain in the gluteal region. Physical examination revealed a porus lateral to the right gluteal region. Lumbar magnetic resonance imaging (MRI)showed osteomyelitis and a minimal occult sacral meningocele in the anterior sacral region. Contrast-enhanced radiographic imaging clearly showed the fistula tract. The patient underwent surgery via the posterior approach; debridement of the sacral osteomyelitis was performed and the fistula tract toward the skin was closed.

Results She was pain free after surgery. There were no postoperative complications.

Conclusıon Although vertebral osteomyelitis due to ASMs is extremely rare, the risk of infection increases in cases of a fistula to the skin. When investigating the etiology of treatment-resistant infections, especially of the skin, sacral osteomyelitis and an underlying anomaly must be kept in mind.

Keywords

anterior meningocele - management - sacral osteomyelitis
 

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