 Redemonstrated are postoperative changes related to resection of the posterior lumbar spine canal lipoma with a minimal residual fat-containing lesion in the operative bed. The residual lesion measures approximately 10 x 4 x 10 mm (TR x AP x CC), previously 10 x 4 x 10 mm. There is an unchanged low-lying conus medullaris terminating at the L4-L5 level. On prone sequence, there is no anterior translation of the cord, suggestive of residual tethering. The vertebral column alignment is otherwise within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. There is persistent linear T2 hypointensity along the surface of the distal conus medullaris, which likely represents chronic blood products. The spinal cord otherwise is unchanged in signal and morphology. There are postoperative changes of the lower lumbar paravertebral soft tissues.
Postoperative findings related to posterior lumbar spinal canal lipoma resection with a small residual lipomatous lesion in the operative bed. The lack of anterior translation of the spinal cord on prone images is unchanged and suggestive of persistent tethering. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.