Urinary difficulties. Evaluate for cord re-tethering. Multiple prior untethering. More recent repair of dural defect and pseudomeningocele in June 20, 2015. Again seen are findings related to prior tethered cord release. Unchanged appearance of the ectatic thecal sac at the lumbosacral junction. The distal spinal cord syrinx shows no significant interval change from the prior examination, which begins at approximately the T12 level and continues to the L4 level with a maximum caliber of approximately 3 x 4 mm, not significantly changed allowing for differences in measurement technique. As on the prior examination, the distal spinal cord is closely opposed and may be adherent to the posterior thecal sac. The cord terminus is difficult to ascertain but it appears to be at the lumbosacral junction. Prone images demonstrate no significant ventral motion.The lumbar lordosis is straightened. Vertebral body height, morphology and signal characteristics are otherwise unremarkable. No evidence of marrow edema or pathologic marrow enhancement is seen. No significant compromise of the spinal canal or neural foramina is seen at any level. No new fluid collections in the paraspinous soft tissues.
1. Postoperative changes related to multiple prior cord untetherings. There is no significant change in appearance and position of the distal cord and cauda equina nerve roots which abut the dorsal thecal sac. No significant motion on the prone sequences. Findings would be compatible with cord re-tethering in the appropriate clinical setting.2. No significant change in small syrinx involving the distal cord.