Clinical question: Status post re-do untethering. Signs and symptoms: As above. Nonenhanced lumbar MRI:Examination demonstrates evidence of tethered cord without convincing evidence of interval change since prior exam. There is no detectable anterior movement of the cord on sagittal T2-weighted images when compared with supine series. This is a similar observation is prior exam. Similar to prior exam there is termination of the cord at S2 level. Visible central canal is again identified in the lower cord without interval change in size or extent. Signal intensity and alignment of vertebral column is within normal without evidence of spinal canal or neural foraminal compromise. Postoperative changes of recent surgery evidenced by postoperative fluid accumulation in the soft tissues over the lower back extending from mid L3-L5-S1 disc level. There is no evidence of mass effect on the spinal canal secondary to this expected postoperative finding. The fluid accumulation measures approximately at 40 x 30 mm in transaxial dimensions.
1.Postoperative changes of redo untethering of the cord evident by posterior lower spine soft tissue fluid accumulation extending from L3 to L5/S1 disc level without mass effect on the thecal sac.2.No convincing evidence of anterior movement of the cord on prone sagittal T2 weighted images compared to supine.3.Revisualization of termination of the cord at S2 level and central canal without change.