 Diffuse atrophy involving the thoracic cord is again noted. There are multilevel laminectomies in the upper and lower thoracic spine as seen before. The upper aspect of the thoracic cord is posteriorly displaced and abuts the dura which may reflect scarring and similar to prior studies. The distal thoracic cord is also posteriorly displaced as before. Again seen is a syrinx extending throughout the thoracic cord. Catheter is present within the superior aspect of the thoracic syrinx and extends inferiorly to the T5 level. Catheter involving the inferior aspect of the syrinx terminates superiorly at the T9 level. Upper aspect of the thoracic syrinx has decreased in size compared to remote MRI study from 5/23/2013. For example at the mid T3 level, syrinx measures 3 x 8 mm, previously 7 x 8 mm. Syrinx at the T6 level measures 4 x 7 mm as before. Syrinx at the inferior T8 level measures 7 x 7 mm previously 6 x 7 mm. There is low T2 signal circumferentially along the dural margin as before which may be reflective scarring, hemosiderin, or mineralization.Thoracic vertebral height heights are maintained. There is straightening of the thoracic kyphosis. Bone marrow signal is benign. No significant spinal canal stenosis or neural foraminal stenosis is evident.LUMBAR SPINE
1. Compared to prior thoracic MRI from 5/23/2013, there is decrease in size of the upper thoracic syrinx and stable to minimal increase in size of the lower thoracic syrinx.2. There is diffuse volume loss of the thoracic cord with areas of posterior displacement involving the upper and lower aspects of the thoracic cord suggesting posterior adhesions. There is also evidence of arachnoiditis involving the cauda equina nerve roots similar to prior.3. Degenerative changes in the lumbar spine as described above including a new T12-L1 disc extrusion. There is no high-grade spinal canal stenosis at any level.