Male, 19 years old, status post recent lumbar untethering of the cord with syrinx, assess for residual abscess. Findings compatible with surgery for tethered cord release are again seen. The lower lumbar and sacral spinal canal is ectatic and in addition has been surgically widened with laminectomy at L5 and perhaps in the sacrum as well. Posterior paraspinal collections which were previously seen in the lower lumbar and sacral regions have almost completely resolved. Only a 1 to 2 mm sliver of fluid persists along the left L4 lamina. No new paraspinal or epidural fluid collections are seen.The distal spinal cord syrinx shows no significant interval change from the prior examination, it begins at approximately the T12 level and continues to the L4 level with a maximum caliber of approximately 3 x 2 mm. As on the prior examination, the distal spinal cord is closely opposed and may be adherent to the posterior thecal sac. The cord terminus is difficult to ascertain but it appears that the cord ultimately tapers and blends with strands of soft tissue which traverse the lower thecal sac. No significant change in cord positioning is seen on prone imaging.The lumbar lordosis is straightened. Vertebral body height, morphology and signal characteristics are otherwise unremarkable. No evidence of marrow edema or pathologic marrow enhancement is seen. No significant compromise of the spinal canal or neural foramina is detected.
1. Redemonstration of findings compatible with spinal cord tethering. The paraspinal fluid collections seen in the operative region on prior examinations have almost completely resolved. Only a thin sliver of fluid persists along the left L4 lamina. No new or worrisome paraspinal or epidural fluid collections are detected.2. The distal spinal cord syrinx is stable in caliber and craniocaudal extent. The appearance of the distal spinal cord is also unchanged.