 Exam is limited by patient motion. The spine is in normal alignment. The vertebral body heights are well-maintained. There is multilevel mild disc narrowing and desiccation along the cervical and thoracic spine. There is a mildly heterogeneous appearance of the bone marrow which is nonspecific. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal. There is apparent increased signal along the medulla and upper cervical cord, although this is favored to be artifactual in etiology. The visualized spinal cord and conus are grossly within normal limits. There is no MR evidence of cord compression or high-grade central spinal canal stenosis. Cauda equina nerve roots do appear to be somewhat dorsally located along the distal spinal canal, to be further assessed on the lumbar spine MRI.Mild degenerative changes are suggested along the cervical spine.Incidental note is made of a large CSF signal intensity structure along the sacrum at the S2-S3 level adjacent to the distal thecal sac, with associated bone remodeling. This structure measures 2.9 cm AP x 3.7 cm CC, corresponding to the area of concern on CT. Of note, there also appear to be prominent nerve root sleeve cysts along the mid to lower thoracic foramina bilaterally.
1. No MR evidence of cord compression.2. CSF signal intensity prominent cystic lesion along the sacrum at the S2-S3 level, corresponding to cystic structure on CT with bone remodeling. Given its CT appearance with more midline positioning and lack of sacral foraminal expansion, this is favored to represent an occult intrasacral meningocele as opposed to a Tarlov cyst. This is to be further detailed on subsequent MRI of the lumbar spine.3. Somewhat dorsal positioning of the cauda equina nerve roots along the distal spinal canal, to be further evaluated on dedicated MRI of the lumbar spine.