Female, 13 years old, lower back pain and leg pain, follow-up pseudomeningocele. The vertebral body naming scheme will remain unchanged relative to prior examinations. As such, the last rib bearing vertebral body will be considered T12. There are 5 lumbar type vertebral bodies with a transitional S1, and a rudimentary disk between S1 and S2.Postoperative findings are again seen compatible with tethered cord repair. The laminae and spinous processes are absent from L3 through the sacrum region.The spinal cord continues to terminate at an abnormally low level, continuing at least to the L4-5 level with placode potentially extending much further inferiorly. The distal cord remains deformed and closely opposed to the posterior right aspect of the thecal sac. The quantity and morphology of fatty material seen along the inferior dorsal thecal sac is similar to the prior examination.The lower thecal sac remains ectatic, perhaps slightly more so than on the prior examination.Spanning the L4 through S1 levels, there remains a fluid collection with CSF signal characteristics immediately dorsal to the deformed distal spinal cord. On sagittal images, this collection measures 65 x 15 mm (image 6 of series 201), previously 69 x 21 mm. A second collection is also seen just above and superficial to the first measuring up to 45 x 15 mm on sagittal images (image 7 series 201), previously only a thin sliver of fluid. These two collections are separated by a thin membrane which may represent dura or duraplasty material, less likely an adhesion (see image 27 series 501).A large subcutaneous collection seen previously overlying the paraspinal musculature has resolved.Multicystic ovaries are partially visualized.
1. Redemonstration of findings compatible with tethered cord and tethered cord repair.2. Interval resolution of the previously seen large superficial subcutaneous fluid collection overlying the paraspinal musculature.3. Slight decrease in size of a CSF-like fluid collection immediately dorsal to the distal spinal canal, with interval increase in size of a second collection superficial to and above the first. These two collections are separated by a thin membrane which may represent dura, duraplasty or less likely an adhesion.