Female, 75 years old, with back pain. Assess for reevaluation of tethered cord or progression of degenerative disc disease. Thoracic:There is a mild scoliotic curvature and slight exaggeration of the thoracic kyphosis, similar to prior. Vertebral body alignment is otherwise unremarkable.Marrow signal characteristics are generally heterogeneous with scattered T1/T2 hyperintense lesions likely representing hemangiomas, without significant interval change. No new or concerning marrow space disease is seen.The visualized spinal cord demonstrates normal signal intensity throughout.Small disc protrusions at T6-7, T7-8, T11-12 and T12-L1 are unchanged. These cause no significant spinal canal stenosis. No high-grade foraminal narrowing is suspected.Lumbar:Redemonstrated is evidence of a posterior instrumented spinal fusion with pedicle screws bilaterally at L4, L5 and S1. The posterior elements in the sacral region are thin or absent which may be postoperative or congenital.A grade 1 anterolisthesis of L4 relative to L5 is not significantly changed. Spinal alignment is otherwise within acceptable limits.Vertebral body height and morphology are normal. Again, marrow signal is generally heterogeneous with scattered superimposed probable hemangiomas. No concerning marrow signal abnormality is detected.The visualized spinal cord and conus demonstrate normal signal characteristics. The conus tip terminates at the L3 level similar to prior. Fatty infiltration of the distal filum terminale is also unchanged.The discs show loss of T2 signal with evidence of loss of disc height at L2-3, similar to prior. Additional level specific findings are as follows:L1-2: Facet hypertrophy and ligamentum flavum thickening. No significant spinal canal or neuroforaminal stenosis. No significant interval changes. L2-3: Marked facet hypertrophy and ligamentum flavum thickening. Mild bulging disc with a right far lateral protrusion versus osteophyte. Mild generalized spinal canal narrowing. Moderate to severe right foraminal narrowing. No significant interval changes. L3-4: Marked facet hypertrophy and ligamentum flavum thickening. Mild bulging disk. Mild generalized spinal canal stenosis. No significant neuroforaminal narrowing. No significant interval changes.L4-5: Marked facet hypertrophy and ligamentum flavum thickening. Mild disc uncovering and minimal disc bulging. No significant spinal canal or neuroforaminal stenosis. No significant interval changes. L5-S1: Unremarkable.
1.No significant interval change in mild degenerative findings of the thoracic spine.2.Redemonstration of postoperative findings in the lumbosacral region. Moderate to severe posterior element hypertrophy, along with relatively mild degenerative disc disease, cause no more than mild spinal canal stenosis. A moderate to severe narrowing of the right L2-3 neural foramen is noted. No significant interval change is seen in these degenerative findings.3.Findings are redemonstrated compatible with tethered cord including low-lying conus and fatty infiltration of the filum terminale without interval change.