Re-do untethering of spinal cord. Additional history from electronic medical record: Ex-31 week preemie. Untethered in 2007 in Madison, Wisconsin, again in 2011. Status post 5 different surgeries to drain abscess in the prior discovered normal sinus tract involving the left buttock. Most recent surgery on 4/4/2016 with untethering of spinal cord by detachment and resection of intradural extent of previously resected subcutaneous dermal sinus track. Completion of laminectomies at L3-L5, and complex wound reconstruction. There has been interval repeat spinal cord untethering surgery. There is no appreciable change in the appearance of the lower spinal cord and conus medullaris, which lies at the L4 level. Likewise, the lipoma along the filum terminale extending from the L5 and S2 is unchanged. The more plaque-like lipomatous mass in the posterior sacral spinal canal is partially-imaged. There is also a partially-imaged band of low T1 signal in the midline posterior sacral soft tissues. The alignment of the lumbar spinal column is normal, with expected lordosis. The vertebral body heights and disc heights are preserved. The vertebral bone marrow signal intensity is normal. There is no evidence of disc herniation or bulge. The right kidney is absent and the left kidney is prominent, likely related to compensatory hypertrophy.
1. Interval repeat spinal cord untethering surgery without appreciable change in the appearance of the lower spinal cord and conus medullaris, which lies at the L4 level. Likewise, the lipoma along the filum terminale extending from the L5 and S2 is unchanged. The more plaque-like lipomatous mass in the posterior sacral spinal canal is partially-imaged. 2. Partially-imaged band of low T1 signal in the midline posterior sacral soft tissues, which may correspond to a residual sinus tract.3. The right kidney is absent and the left kidney is prominent, likely related to compensatory hypertrophy.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.