Spinal meningoceles are congenital anomalies characterized by meningeal herniation through vertebral defects, most commonly occurring in the lumbosacral region. Intrathoracic meningoceles are rare and are typically associated with neurofibromatosis type 1 (NF-1). True anterior thoracic meningoceles unassociated with NF-1 represent exceptionally rare clinical entities. This is a retrospective case report. We report a 15-year-old female with severe kyphoscoliosis and a non-NF-1-associated anterior thoracic meningocele who presented with progressive spastic paraparesis. Imaging examinations revealed thoracolumbar scoliosis with 100-degree kyphotic angulation, midline anterior spina bifida at T7, and a well-defined cystic structure exhibiting hypointense T1 and hyperintense T2 signals (measuring 5.7×4.5 cm) anterior to the T7-T8 vertebral bodies. Surgical intervention included posterior spinal laminar decompression, T7 vertebral osteotomy, microscopic dural sac reduction, and stabilization using a pedicle screw system with autologous bone grafting. The patient was discharged without any complications 12 days after surgery, and at the 12-month follow-up, the patient achieved ambulation with a walker and leg brace. This case underscores the necessity of tailored surgical strategies for anterior thoracic meningoceles complicated by severe spinal deformities. The integration of microsurgical techniques and 3D-printed anatomical modeling may optimize procedural safety and functional outcomes.

Anterior sacral meningocele is a rare congenital disorder, occurring isolated or in syndromic disease. A 15-year-old patient who complained of abdominal pain and urinary dysfunction was managed surgically. Imaging diagnosed a giant presacral meningocele and agenesis of the coccyx. The presentation of sacral meningocele can be poorly symptomatic, which is why some patients are diagnosed late. Sometimes, diagnosis is suggested by non-specific abdominal symptoms or complications. Abdominal-pelvic radiological examination and lumbar spine MRI are essential, and treatment must be surgical. There are several surgical approaches, but currently no consensus. An unusual huge presacral cystic mass in a young patient may be isolated or part of a syndrome, and can be asymptomatic for a long time, leading to late diagnosis. The surgical approach should be based on multidisciplinary discussion. We operated on a giant anterior sacral meningocele in a child using a posterior approach, with a satisfactory result.

Anterior cervicothoracic myelomeningoceles are a rare pathology. In reported cases, treatment has included shunting, isolated resection and repair without deformity correction, or isolated deformity correction without meningocele repair. The authors describe a pediatric patient with an anterior cervicothoracic myelomeningocele presenting with progressive neurological decline, who underwent simultaneous treatment of the myelomeningocele to detether the spinal cord and achieve major correction of the scoliotic deformity. A 15-year-old girl was born with C7-T1-T2 hemivertebrae and anterior cervical myelomeningocele at C7-T1. She developed progressive cervical thoracic scoliosis, left hemiparesis initially, and additional right hemiparesis eventually. She underwent surgical repair via C7, T1, and T2 corpectomies with intradural detethering of the spinal cord. The scoliosis was treated with C7-T2 Ponte osteotomies and C2-T5 posterior fixation, followed by anterior reconstruction with a titanium cage and anterior plate from C6 to T3. The myelomeningocele was adequately treated with good correction of the patient's deformity. The patient had postoperative improvement in her strength and solid arthrodesis on postoperative imaging. The authors describe the successful treatment of an anterior cervicothoracic myelomeningocele and associated scoliosis in a child. This is a unique report of a combined strategy to achieve both deformity correction and detethering of the spinal cord.

Posterior cervical meningoceles are rare in adults because most are surgically excised early in life. Such meningoceles in adults are mostly presented as a cystic mass and their presentation as a solid mass is very rare. An asymptomatic adult with cervical meningocele presented as a congenital midline skin covered solid mass in the posterior aspect of the neck is presented. Neuroradiological surveys showed attachment of the mass to intradural spinal cord. With diagnosis of a cervical meningocele, after excision of the solid sac, the stalk extending from the core of the mass to the dura was isolated. This was followed by intradural spinal cord detethering. The mass was compatible with rudimentary meningocele in pathology. Neglected cervical meningocele is quite rare in adults. Surgical removal of the mass in adults is usually for cosmetic reasons rather than neurological impairment. However, surgical removal of the mass without intradural cord detethering is not sufficient. In such cases, late onset quadriparesis may be appear due to the spinal cord tethering scenario.

Cranial nerve lesions can be secondary to a space-occupying lesion of the skull base compressing adjacent nerves. We report the case of an 84-year-old man, who presented with rapid and concomitant onset of dysphagia and ipsilateral recurrent laryngeal nerve paralysis, suggesting an isolated lesion of the vagus nerve. MRI revealed a diagnosis of previously unknown clival meningocele. Unilateral vagus nerve paralysis constitutes an exceptional mode of presentation of meningocele. Only a few isolated cases of clival meningocele have been reported to date, with no cranial nerve repercussions. The symptomatic management adopted in this case allowed rapid improvement of the patient's disorders.