 The lumbar spine is in normal alignment, with straightening of normal lumbar lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. There are postsurgical findings of laminectomy from L2-L5 levels and changes related to tethered cord release. The conus terminates at the L4-L5 level. Probable developmental dysraphism of the sacrum is again noted. There is redemonstration of a dilated central canal involving the distal spinal cord which is most pronounced at L3 level measuring 8 mm x 6 mm x 39 mm (AP by transverse x craniocaudal dimensions) previously 9 mm x 6 mm x 39 mm. Hyperintense T1 and T2 lesion is again seen eccentric along the distal thecal sac consistent with a lipoma. There is a plaque-like area of additional fat signal extending distally distal to the sac in the area of dysraphism, unchanged from piror examination. There is no significant ventral motion of the distal spinal cord and conus on prone imaging although there is motion involving the more proximal cord.There is a partially visualized syrinx involving the thoracic spinal cord at the T9 level measuring 4 x 4 mm. The syrinx was present on recent prior studies although not completely included in the field-of-view, limiting comparison. There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the lumbar spine.A small amount of pelvic free fluid is again demonstrated.
1.Postsurgical changes of laminectomy and tethered cord release with persistent low lying conus. The lumbar syrinx appears similar to prior examination. There is no significant ventral motion of the distal cord on prone imaging similar to prior examination. Again, this may relate to possible re-tethering in the appropriate clinical setting.2. There is a partially visualized small syrinx involving the thoracic cord which was present on recent prior examinations although not completely included in the field-of-view and therefore comparison is limited. If further evaluation is needed, dedicated imaging of the thoracic spine may be considered. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.