Status post Chiari decompression on 3/10. Postop follow-up. There are postoperative changes of suboccipital craniectomy and C1 laminectomy with interval increase in CSF spaces in the posterior fossa. Posterior fossa is well decompressed. There is good biphasic CSF flow ventrally and dorsally at the foramen magnum.The cervical vertebral bodies are appropriate in height. Alignment is maintained. Bone marrow signal is benign with T1 hyperintense lesion involving the left aspect of the C7 vertebral body compatible with a small hemangioma. Examination is motion degraded, however, no obvious cord signal abnormality or evidence of syrinx is appreciated. There is T2 hyperintensity in the pons which was present on prior brain MRI and may be related to small vessel ischemic disease.Mild degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: No significant compromise to the spinal canal or neural foramina.C4-5: No significant compromise to the spinal canal or neural foramina.C5-6: No significant compromise to the spinal canal or neural foramina.C6-7: Left paracentral disc extrusion with mild craniocaudal extension and associated mild stenosis involving the left aspect of the spinal canal. There is also mild left neural foraminal stenosis. Right neural foramen is patent. Prior imaging demonstrates minimal disc bulge at this level.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. Expected postoperative changes of Chiari decompression. Posterior fossa structures are well decompressed with good biphasic CSF flow ventrally and dorsally at the foramen magnum. No appreciable cord signal abnormality or syrinx within the limits of a motion degraded study.2. Mild degenerative changes in the cervical spine including left paracentral disc extrusion at C6-C7 which is new since prior study from 9/29/2015.