NF1, scoliosis, paraspinal plexiform tumor. Evaluate for change. Since the prior MRI, interval postsurgical changes of posterior spinal fusion are evident throughout the thoracic spine. Hardware integrity can be better assessed with radiographs or CT. Susceptibility artifact limits evaluation.As demonstrated previously, the neural foramina and paraspinal soft tissue structures are again notable for a left sided plexiform neurofibroma spanning T2 through T10, measuring approximately 10 cm in the craniocaudal dimension. There appears to be some interval resection involving the posterior subcutaneous/paraspinous aspect of the tumor. Extension into the paraspinal muscles to the right of the spinous process and along the left chest wall and extrapleural space, appearing to involve some of the intercostal nerves in the left chest again seen. No area of enlargement is seen to suggest malignant degeneration. Severe levoscoliosis in the upper thoracic spine as well as exaggerated thoracic curvature appear improved in the interval and can be better assessed with standing radiographs as clinically indicated. Cord contour deformity related to the curvature is again seen without clear evidence of significant spinal canal stenosis at any level within the limits of susceptibility artifact from the hardware.Vertebral body heights and alignment in the lumbar spine are normal. Bone marrow signal is normal. No evidence of tumor in the lumbar spine. No significant spinal canal or neural foraminal stenosis seen at any level in the lumbar spine.
Compared to prior MRI from 1/8/2013, interval postsurgical changes of posterior spinal fusion involving the thoracic spine are seen. Severe levoscoliosis in the upper thoracic spine as well as exaggerated kyphosis appear improved. There appears to have been partial resection of the posterior paraspinous aspect of the plexiform tumor which extends from T2 to T10 as described above; extent of resection can be better assessed with outside operative note or immediate postoperative imaging. No new area of tumor is seen to definitively suggest enlargement. Note due to susceptibility artifact from the hardware small areas of epidural and neural foraminal tumor are difficult to assess.