History of Chiari decompression and tethering, syrinx and T2 signal change, 6 month follow up. Left arm burning. Removal of syringo-subarachnoid shunt on November 28, 2013. Cervical:Again seen are suboccipital postoperative changes of Chiari decompression with preservation of the ventral and dorsal CSF spaces at the foramina magnum. There is faint patchy T2 signal in the cervical cord similar to prior with minimal prominence of the central canal in the upper cervical cord, which is not significantly changed. No discrete syrinx is appreciated within the cervical cord. There is preserved biphasic CSF flow at the foramina magnumAgain seen are degenerative changes in the cervical spine with mild retrolisthesis of C3 on C4, C4 and C5, and minimal at C5 and C6. Disk osteophyte complexes result in mild to moderate spinal canal stenosis at C3-C4 and C4-C5. There is mild to moderate left C4-C5 neural foramina stenosis.THORACIC: Again seen are postsurgical changes of laminectomy at the T1 and T2 levels. Again seen is dorsal displacement of the thoracic cord at the T1-T2 level which appears tethered to the dorsal thecal sac surface. There is mild patchy T2 signal including myelomalacia compatible with postsurgical change. There is minimal prominence of the central canal in the upper thoracic cord with small cystic cavity at the T1-2 level, which is well seen on the 3D T2 BFFE sequence. Overall findings are similar to 8/6/2014.The thoracic spine is in normal alignment, with slight exaggeration of the normal thoracic kyphosis. The vertebral body heights are well maintained. The remainder of the thoracic spinal cord is of normal caliber and signal. Degenerative changes are seen throughout the thoracic spine with small disk bulges without significant spinal canal or neural foramina stenosis.
1.Postoperative changes of Chiari decompression with preserved CSF flow at the foramen magnum.2.Unchanged mild patchy T2 signal within the cervical cord and trace prominence of the central canal in the upper cervical cord. No discrete syrinx.3.Postoperative changes of upper thoracic laminectomy. Unchanged appearance of the upper thoracic cord which appears dorsally tethered. Stable T2 signal abnormality which in part is related to myelomalacia with minimal residual upper thoracic syrinx.4.Moderate degenerative changes in the cervical spine with mild to moderate spinal canal stenosis at C3-C4 and C4-C5, and mild stenosis at C5-C6. There is also mild to moderate left neural foraminal narrowing at the C4-C5 level.