Clinical question: History of cervical thoracic syrinx. Evaluate resolution post shunting. Signs and symptoms: Spasticity, LE weakness. Nonenhanced several MRI:Examination redemonstrates syrinx the cervical cord extending from C1 through the entire cervical cord and into the thoracic cord. Compared to prior exam there is interval decreased caliber of syrinx without change in its extent.The syrinx measures 6.7 x 3.2-mm in transaxial dimensions at C3 -- C4 disk level compared to prior study measurements of 7.4 x 4.2-mm.At T7 the syrinx measures approximately 9.9 x 3.2-mm compared to prior study measurements of 12 x 4-mm.Moderate degenerative changes of disk mild hypertrophic changes of the posterior elements demonstrate no significant change. There is no evidence of central spinal stenosis at any level.Nonenhanced thoracic MRI:Similar to MRI of cervical spine there is interval decreased size of syrinx of thoracic cord however without change in its extent.The syrinx extends inferiorly to approximately T11 similar to prior study. It measures 8mm in transverse axis at T4 level compared to prior study measurement of 9mm.Suboptimal quality of the axial images makes precise measurement inferiorly more difficult.There is no evidence of spinal stenosis at any level. The alignment of the vertebral column remains within normal and there is no evidence of central spinal stenosis.Nonenhanced lumbar MRI:Examination demonstrates normal anatomical alignment of vertebral column. There is however mild exaggeration of lumbar lordosis.There is no evidence of spinal stenosis at any level. There is termination of the cord at L1 level. The signal intensity and caliber of conus or is within normal. There is no detectable signal abnormality of the cauda equina however axial T1-weighted images were not acquired this study. There are also no prior MRI at lumbar spine for comparison.T12 -- L1 demonstrate moderate disk disease and loss of disk height without spinal stenosis or neural foramina compromise.L1 -- L2 demonstrate mild disk disease and mild bilateral facet and ligamenta flava hypertrophy. No spinal stenosis or neural foramina compromiseL2 -- L3 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.L3 -- L4 demonstrate mild disk desiccation and mild bilateral facet and ligamentum flavum hypertrophy. No spinal stenosis or neural foraminal compromise.L4 -- L5 demonstrate mild disk disease and moderate bilateral ligamentum flavum hypertrophy and mild facet hypertrophy. No spinal stenosis or neural foraminal compromise.L5 -- S1 demonstrate moderate disk disease and loss of disk height, moderate bilateral facet hypertrophic changes and mild to moderate ligamentum flavum hypertrophy. There is shallow diffuse disk bulge present at this level with resultant subtle indentation of the thecal sac.No central spinal stenosis however moderate to severe bilateral neural foraminal compromise is present at this level.
1.Nonenhanced MRI of the cervical spine demonstrate interval decreased size of syrinx of cervical cord as detailed/measured above.2.Nonenhanced MRI of the thoracic spine also demonstrate mild interval decreased size of syrinx.3.There is no change in the length of syrinx which extends from C1 to approximate the T11 level.4.There is no evidence of spinal stenosis in the cervical or thoracic spine.5.MRI of lumber spine demonstrate no detectable cauda equina abnormality, no spinal stenosis, moderate to severe bilateral neural foraminal compromise at L5 -- S1 and patent at all other levels.