History of tethered cord. There are postoperative findings related to what appears to be prior dethetering surgery, including lumbosacral laminectomies. There is diffuse elongation and thinning of the spinal cord with a low lying conus medullaris at the L5 level. There is also a fat signal intensity mass that measures up to 21 mm associated with the cauda equina nerve roots at the L5-S1 level, abutting the posterior dura. There is also a subcentimeter globular area of low T1 and T2 signal to the right of the mass, which may represent clumped nerve roots and/or scar tissue. There is no appreciable translation of the spinal cord on prone versus supine positioning. The spinal cord signal is otherwise unremarkable. There are multiple intravertebral disc herniations, but now spinal canal or neural foraminal stenosis. The vertebral body heights are otherwise preserved and the bone marrow signal is unremarkable. The vertebral column alignment is anatomic.
Postoperative findings in the lumbosacral region with a low lying conus medullaris at the L5 level and a lipomatous mass associated with the cauda equina nerve roots at the L5-S1 level, abutting the posterior dura. The constellation of findings suggests persistent tethered cord.