Syrinx, tethered spinal cord and back pain. For the purposes of numbering, the most inferior well-defined disc space is labeled L5-S1. Low-lying conus near the lumbosacral junction and postoperative changes related to prior cord untetherings again seen. Distal thecal sac is ectatic and demonstrates septations, findings which are not appreciably changed. As before, the distal spinal cord abuts and may be adherent to the posterior thecal sac. Cauda equina nerve roots are also peripherally located as seen before which may also be reflective of adhesion/arachnoiditis. Prone images demonstrate no appreciable ventral motion of the distal cord again raising possibility of re-tethering in the appropriate clinical setting.No significant change in diameter or craniocaudal extent of visualized distal cord syrinx extending from approximately the L1 to the L3-L4 levels and measuring up to 2 x 4 mm in the axial plane. Syrinx is decreased in size when compared to earlier MRI from 3/30/2016.Alignment is anatomic. Vertebral body heights and intervertebral disc spaces are preserved. The bone marrow demonstrates a normal signal. No spinal canal or neural foraminal stenosis is seen at any level.
1. No significant change in examination compared to 7/14/2016 including the small distal cord syrinx. Syrinx is mildly decreased in size when compared to 3/30/2016. 2. There is no significant ventral motion of the distal cord in the prone position raising possibility of re-tethering, although this finding has been present on multiple prior studies.