Female, 47 years old, history of coccygeal/sacral chordoma status post resection. Surveillance scan. There are postoperative changes involving the lower sacrum with absence of the coccyx. Mild enhancement in the surgical bed likely represents scar tissue. This region is better assessed on the accompanying pelvic MRI.Fatty signal within the S2 and S3 vertebral bodies is again seen similar to prior compatible with focal fat or hemangiomas. No evidence of suspicious T2 hyperintensity or pathologic enhancement is seen at these levels.Elsewhere in the lumbar spine, no pathologic marrow signal alteration or enhancement is seen. Vertebral body height and morphology is normal. The visualized spinal cord, conus and cauda equina are unremarkable.L1-2: No significant disk disease. No spinal canal or neural foramina stenosis.L2-3: No significant disk disease. No spinal canal or neural foramina stenosis.L3-4:Disc protrusion is again seen. No significant spinal canal stenosis. Minimal right foraminal narrowing. No left foramina narrowing.L4-5:Minimal disk bulge. Left dorsal annular fissure. No significant spinal canal stenosis.Minimal bilateral foraminal narrowing.L5-S1: New left paracentral disc protrusion with increased effacement of the left lateral recess and contact of the descending left S1 nerve root. No significant central canal stenosis or neural foraminal stenosis.Mild facet arthropathy in the lumbar spine. Paraspinous soft tissues are unremarkable.
1. Postsurgical changes in the sacrococcygeal region are only partly visualized on this examination. No evidence of residual or recurrent tumor is seen. Please see separate report from accompanying pelvic MRI.2. Mild degenerative changes in the lumbar spine as described above with interval increase in left paracentral disc protrusion at L5-S1.