Follow-up exam. History of prior thoracic fenestration. Thoracic: Vertebral body heights are normal. There is thoracolumbar levocurvature and exaggerated lumbar lordosis. Marrow signal is normal for age. Again seen is evidence of fenestration of the arachnoid cysts with laminoplasty from T2 to T9. Evolution of postsurgical changes is evident with resolution of previously seen edema in the posterior soft tissues with persistent fluid dorsally at the level of the laminoplasties without any mass effect on the thecal sac. No mass effect on the cord is seen to suggest residual or recurrent arachnoid cysts, which were evident on prior myelogram at the T3-T4 level and T7-T8 level.No cord signal abnormality or syrinx is appreciated. The lower thoracic cord and conus with improvement in previously seen clumped appearance of the right-sided nerve roots. No spinal canal or neural foraminal stenosis.There is bibasilar atelectasis Lumbar: There is exaggerated lumbar lordosis with near 90 degree curvature at the lumbosacral junction, more prominent in comparison with prior images from 12/22/2014. Vertebral body heights and alignment are otherwise maintained. Conus is in normal position (L2 level, counting from craniocervical junction previously) without suspicious lesions involving the lumbar spinal canal. No lipoma or appreciable thickening of the filum. Conus and cauda equina nerve roots are rightward positioned favored to be related to the spinal curvature. No significant clumping of the nerve roots is appreciated. No spinal canal or neural foraminal stenosis. Prone images demonstrate no significant motion of the conus and cauda equina nerve roots.
1.Evolution of postsurgical changes related to fenestration of thoracic arachnoid cysts. No mass effect on the thoracic cord is seen to suggest recurrence of the previously seen cysts. No cord signal abnormality or evidence of syrinx.2. Mild rightward deviation of the distal spinal cord and cauda equina nerve roots is again noted which is favored to be related to thoracolumbar levocurvature. 3. When compared to MRI spine study from 12/22/2014, the thoracolumbar levocurvature and exaggerated lumbar lordosis including near 90 degree curvature at the lumbosacral junction appears to have progressed. Would suggest correlation with radiographs.4. Prone images demonstrate no significant ventral motion of the conus in the prone images, finding which was present on 12/22/2014. Although the conus is not low-lying and there is no obvious thickening or lipoma of the filum, tethering cannot be entirely excluded by imaging and would suggest correlation with clinical findings.