Male, 19 years old, with spina bifida, status post spinal cord untethering, with syrinx, presenting with urinary changes and back pain. Redemonstrated is evidence of spinal cord untethering. The lower thecal sac remains ectatic. As before, the distal spinal cord abuts and may be adherent to the posterior thecal sac. The location of the conus tip is difficult to assess but probably occurs at the lumbosacral junction. No evidence of spinal cord ventral motion is seen on prone imaging. The previously demonstrated spinal cord syrinx shows no significant interval change. As before, it begins at T12 or L1 and continues down to the L4 level. The maximum caliber of the syrinx remains 4 x 3 mm.The typical lordotic curvature of the lumbar spine is straightened but alignment is otherwise unremarkable. Vertebral body height and morphology are within normal limits. No marrow signal abnormalities are detected. The intervertebral discs are preserved. No significant compromise of the spinal canal or neural foramina is seen.
1.Evidence of prior spinal cord untethering is seen. The cord remains closely apposed and possibly adherent to the posterior thecal sac. No evidence of cord motion is seen on prone imaging.2.The previously demonstrated distal spinal cord syrinx has not significantly changed in maximum caliber or craniocaudal extent.3.No other significant spinal abnormality is seen to account for the patient's symptoms.