Clinical question: Three months follow-up post tethered cord release. Signs and symptoms: Status post tethered cord release. Nonenhanced lumbar MRI:The alignment of vertebral column is anatomical.The signal intensity of vertebral column demonstrate changes from prior surgery and mild degenerative disease.T11 -- T12, T12 -- and one, L1 -- L2 and L3 -- L4 levels are unremarkable.L4 -- L5 demonstrate mild disk disease and facet/ligamentum flavum hypertrophy. No spinal stenosis or neural foraminal compromise. There is a small linear focus of T2/T2 stir hyperintensity in the midline of the annulus of the disk and consistent with an annular fissure.L5 -- S1 demonstrate mild disk disease and without spinal stenosis or neural foraminal compromise. Similar to L4 -- L5 level there is a midline annular fissure. Examination demonstrates post operative changes off laminectomy at L5 level for cord untethering. There are no prior exams for comparison. Sagittal prone images demonstrate forward movement of the cord from T10 to L4 disk level and without evidence of movement from this level inferiorly. Fatty signal intensity of filum terminalis at the L5 -- S1 disk level is noted. The conus is suspected to terminate posteriorly at approximately L4 -- L5 disk level.There is small fluid accumulation in the subcutaneous fat and posterior to the interspinous ligament and surrounding the L5 spinous process suggestive of a postoperative finding. There are no prior exams for comparison. The signal intensity of the adjacent bony structures are unremarkable.
1.Prone sagittal T2 weighted images demonstrate forward movement of the cord from T10 to L4 level.2.There is termination of the cord at L4 -- L5 level posteriorly. Fatty signal intensity of filum at S1 is noted.3.Postoperative thin layer of fluid collection in the subcutaneous fat extending from L4 through S2 levels as detailed. No prior exam for comparison.4.Midline annular fissure at L4 -- L5 and L5 -- S1 levels. No spinal stenosis or neural foraminal compromise.