Tethered cord with worsening symptoms , 3 -4 month MRI follow up MRI thoracic spine:The patient status post laminectomies from T8 through T11.There is redemonstration of a multicystic syrinx associated with distortion of the thoracic spinal cord extending from T9 inferiorly. The inferior tip of the conus medullaris is at the L1 vertebral body level. In general this appearance remains stable when compared to a prior exam from 1/8/2015 and 9/15/2014.There is a fluid collection behind the thecal sac which measures 50 mm superior-inferior dimension and approximately 2 7-mm AP dimension. There was also present on the prior exam and has not changed substantially. It extends from the T9 vertebral body level to the T11 vertebral body level. It does not appear to compress the spinal cord.Comparison sagittal prone to supine MRI appears that the spinal cord appears to the posterior aspect of the thecal sac at the T12 vertebral body level in the possibly adheres to be anterior aspect of the thecal sac at the T10 vertebral body level. This raises the question of some associated arachnoiditis. The cauda equina moves anteriorly.The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. Lumbar spine:Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. There is a multicystic syrinx present in the lower spinal cord.Comparison sagittal prone to supine MRI appears that the spinal cord appears to the posterior aspect of the thecal sac at the T12 vertebral body level in the possibly adheres to be anterior aspect of the thecal sac at the T10 vertebral body level. This raises the question of some associated arachnoiditis. The cauda equina moves anteriorly.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is mild facet hypertrophy at this level.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is mild ligamentum flavum hypertrophy at this level.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.A multicystic syrinx in the lower spinal cord appears to be associated with findings suggestive of arachnoiditis. The extent and appearance of the syrinx remains stable when compared to the previous exam.2.The patient is status post multilevel laminectomies in the lower thoracic spine. A small fluid collection behind the thecal sac remains stable when compared to the previous exams