Male, 43 years old,spinal cord syrinx, follow-up. Thoracic: There is significant volume loss involving the thoracic cord at the level of the syrinx as well as of the mid thoracic cord above the syrinx. Again demonstrated is a syrinx extending from the T8 to T10 levels which is overall not significantly changed since 8/20/2015. At the T8 level there is a locule in the right aspect of the syrinx previously measuring 7.5 x 6.6 mm, now 7.1 x 8.0 mm. At the T9 level a locule measures 6.7 x 7.1 mm, previously 5.6 x 5.9 mm.Exaggerated thoracic kyphosis is redemonstrated with small Schmorl's nodes suggestive of Scheuermann's. Again seen are multilevel laminectomies. Syrinx shunt catheter is poorly visualized. Fatty endplate signal change is seen at the superior endplate of T7, unchanged. No areas of high-grade spinal canal or neuroforaminal stenosis are appreciated.Lumbar:The conus and cauda equina are within normal limits. The conus tip terminates at the upper margin of L2 which is within normal limits.Vertebral body heights are normal. Bone marrow signal is benign. Grade 1 retrolisthesis of L4 relative to L5 is again seen. Alignment is otherwise unremarkable. Edematous endplate marrow signal changes at L5-S1 appear slightly decreased. Disc desiccation at L3-L4, L4-L5, and L5-S1 is again seen with particular loss of disc height at the L5-S1 level. Individual levels as below: L1-2: No spinal canal stenosis or neuroforaminal narrowing. L2-3: No spinal canal stenosis or neuroforaminal narrowing. L3-4: Facet hypertrophy. Mild bulging disk. No significant spinal canal or neuroforaminal stenosis. No interval changes.L4-5: Facet hypertrophy. Disc bulge. No significant spinal canal stenosis. Mild bilateral foraminal narrowing.L5-S1: Facet hypertrophy. Diffuse disc bulge again seen including involvement of the neural foramina. No significant spinal canal stenosis. Mild to moderate bilateral neural foraminal stenosis.
1. Overall no significant change in size and extent of septated lower thoracic syrinx. There are small loculated areas which demonstrates subtle changes in morphology and perhaps minimal enlargement as detailed above compared to 8/20/2015. 2. Significant parenchymal volume loss involving the thoracic cord at the level of the syrinx as well as above it involving the mid thoracic cord. 3. Mild degenerative changes in the lumbar spine.