Status post ependymoma resection Interval postsurgical changes of C4 to C7 laminectomy, myelotomy, and resection of enhancing intramedullary lesion (which extended from upper C5 to lower C7 levels) are seen. Posterior spinal fusion hardware with paraspinous rods and lateral mass screws are seen extending from C4 to C7. Susceptibility artifact slightly limits evaluation; there is however no evidence of residual tumor. T2 hyperintensity is seen within the cord reflecting resection cavity with mild surrounding edema. T2 hypointensity at the C7 level is compatible with hemosiderin deposition related to remote hemorrhage. There is mild intrinsic T1 hypointensity without definite enhancement.Expected postsurgical changes include fluid and blood products in the surgical bed. No large hematoma or evidence of significant mass effect on the cord is appreciated. There is effacement of the ventral and dorsal thecal sac from C4 to C7 levels which was present on the preoperative study. Small disc osteophyte complexes with disc bulges are noted at C5-C6 and C6-C7 levels with mild thickening along the posterior longitudinal ligament. Neural foramina are patent. Vertebral body heights and alignment are maintained. Bone marrow signal is unremarkable.
1. Expected postsurgical changes of cervical intramedullary tumor resection as described above. There is hemosiderin deposition related to remote hemorrhage associated with the ependymoma at the C7 level but without abnormal enhancement on the current study. No convincing evidence of residual tumor.2. Posterior spinal fusion hardware from C4 to C7 appears well-positioned but can be better assessed with radiographs or CT.