Diagnosis: Syringomyelia and syringobulbia Arnold-Chiari syndrome without spina bifida or hydrocephalusClinical question: Syrinx, yearly eval for changes/sizeSigns and Symptoms: yearly eval of syrinx Cervical spine:There is redemonstration of an 8 mm x 6 mm axial dimensions syrinx extending from the C5-6 disc space level down to the upper thoracic spine and centered at C7 which previously measured approximately 7 x 5 mm axial dimensions and extended from the C5-6 disc level. On the 2013 exam it measured 4.5 x 6 mm axial dimensions.The patient is status post Chiari decompression.The cervical vertebral bodies are appropriate in overall alignment and height. At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.MRI thoracic spine:The syrinx extends down to the C6-7 disc space level on the current exam and previously extended down to approximately the same level.The thoracic vertebral bodies are appropriate in the overall alignment and height. There is no compromise of thoracic spinal canal or exiting nerve roots.
Compared to prior exams over the past 2 years the patient's syrinx is currently larger in axial dimensions at the C7 vertebral level. The superior and inferior extent of the syrinx appears approximately the same.