Tethered cord and Chiari status post spinal cord untethering. Brain: The cerebellar tonsils extend up to 5 mm inferior to the foramen magnum with apparently diminished flow of cerebrospinal fluid across the posterior aspect of the foramen magnum. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift. The major cerebral flow voids are intact. There is fluid within the right mastoid air cells. The orbits, skull, paranasal sinuses, and scalp soft tissues are partly obscured by dental brace artifact.Cervical Spine: There are interval postoperative findings in the lumbar spine related to tethered cord surgery via L4 osteoplastic laminoplasty. The conus medullaris remains positioned at the L1-2 level. There is upper thoracic levoscoliosis, thoracolumbar dextroscoliosis and lower lumbar levocurvature, but no spondylolisthesis. The spinal cord displays normal signal and morphology. There is no evidence of fibrofatty filum. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis.
1. Persistent upper thoracic levoscoliosis, thoracolumbar dextro scoliosis and lower lumbar levocurvature. 2. Mildly low-lying cerebellar tonsils without evidence of syringomyelia. 3. Interval tethered cord surgery. The conus medullaris remains positioned at the L1-2 level. 4. No evidence of ventriculomegaly.5. Fluid within the right mastoid air cells may be due to effusions.