 The thoracic spine is in normal alignment, with a normal thoracic kyphosis. The vertebral body and disk heights are well maintained. No worrisome focal marrow signal abnormality is appreciated.There is redemonstration of focal bilobed appearing T2 hyperintensity within the center of the cord spanning the T1 and T2 levels, with more cranially extending abnormal signal into the lower cervical cord. This measures up to 7 x 6 mm in greatest axial dimensions at the upper T2 level on 901/20, compared to previous remeasurement of 6 x 5 mm at the same level. More ill-defined T2 hyperintensity is seen within the center of the cord extending to the mid T3 level, also similar to prior. No other thoracic cord signal abnormality is appreciated.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the thoracic spine.Crowding of the foramen magnum due to abnormal caudal extension of cerebellar tonsillar is only partially visualized on the counting sequence. Extensive abnormal T2 hyperintense signal within the lower cervical cord appears slightly more extensive although not well assessed.LUMBAR SPINE
1. Transitional lumbosacral anatomy as detailed above. If surgery is to be contemplated, correlation with imaging of entire spine is recommended.2. Redemonstration of cervicothoracic syringohydromyelia, appearing very slightly intervally increased in size since prior dedicated brain/cervical exam. Syrinx only extends to the T2-T3 level although there is additional likely soft syrinx to the mid T3 level.3. Known Chiari I malformation not well assessed on this exam.