 There are 5 lumbar type vertebral bodies. Compared to 9/9/2015, interval postsurgical changes of L1-L3 partial laminectomy and laminoplasties are seen. Again seen are multiple expansile lesions involving the distal thoracic cord with enhancement likely representing multiple ependymomas as well as multiple extramedullary lesions compatible with schwannomas along the cauda equina nerve roots. There appears to be total or near total resection of the previously described L2-L3 level mass previously measuring 13 x 12 x 17. There may have been partial debulking of additional lesions and can be correlated with surgical history. Expected postsurgical changes are seen in the paraspinous soft tissues without fluid collections. No new signal abnormality involving the conus.Vertebral body heights in the lumbar spine are normal. Alignment is grossly maintained. Additional nerve sheath tumors are evident in the neural foramina which are relatively small. There is a relatively larger one involving the left L5 nerve root measuring approximately 13 x 20 mm in the AP and transverse dimensions. Nerve sheath tumors involving the sacral foramina are partially visualized involving the left S1 nerve root. There is also an enhancing lesion at the level of the L3-L4 facet joint on the left, also likely a nerve sheath tumor. These are not appreciably changed since 9/9/2015. Large retroperitoneal, suprarenal mass is again seen and partially imaged.
Again seen is stigmata of NF 2 with multiple intramedullary enhancing masses involving the distal cord, which likely represent ependymomas, as well as multiple extramedullary lesions compatible with meningiomas as well as schwannomas involving the cauda equina nerve roots. Interval total or near total resection of the previously seen large schwannoma which occupied majority of the spinal canal at the L2-L3 level is noted. Additional debulking may have been performed of the lesions along the surface of the conus which appear slightly smaller but difficult to precisely compare, and can be correlated with surgical history.