Can't move legs. Per chart history of spina bifida and multiple spinal cord and tethering procedures. Last surgery was on 10/6/2015 Compared to 7/29/2015, interval postsurgical changes of redo cord untethering are seen. Again seen is evidence of prior lipomyelomeningocele and multiple prior spinal surgeries. There is wide laminectomy at the L4-L5 level. Dysplastic/dysraphic posterior elements at the L5-S1 level also noted. Cord again noted to terminate near the L4-L5 level with the distal cord abutting the posterior margin of the thecal sac. Scar tissue is evident involving the thecal sac at the L5-S1 level.There has been development of a fluid collection in the posterior paraspinous soft tissues extending from the mid L3 to the upper S1 levels measuring approximately 2.5x4.4x6.6 cm. Smaller fluid collections extending towards the skin surface are also seen more superficially.Vertebral body heights and alignment are maintained. No significant disc disease. No spinal canal or neural foraminal stenosis at any level. No evidence of epidural hematoma.
Again seen is evidence of multiple cord untetherings related to lipomyelomeningocele. There has been development of a posterior paraspinous fluid collection measuring approximately 2.5 x 4.4 x 6.6 cm extending from the mid L3 to the upper S1 levels likely representing a pseudomeningocele. Additional smaller pockets of fluid are also seen extending toward the skin surface.No evidence of mass effect on the thecal sac. No hematoma within the spinal canal. No significant spinal canal or neural foraminal stenosis.