Male, 43 years old,spinal cord syrinx, 6 month follow-up. Thoracic:There is significant volume loss involving the thoracic cord the level of the syrinx as well as of the mid thoracic cord above the syrinx. Again demonstrated is a syrinx extending from the T8 to T10 levels which is overall not significantly changed since 12/18/2014. At the T9 level syrinx is slightly smaller measuring 5.9 x 5.6 mm, previously approximately 7.6 x 6.6 mm. At the T8 level there is a locule in the right aspect of the syrinx previously measuring 4.8 x 4.1 mm and now larger, at 7.5 x 6.6 mm. Exaggerated thoracic kyphosis is redemonstrated. Again seen are multilevel laminectomies. Syrinx shunt catheter is poorly visualized. Fatty endplate signal change is seen at the superior endplate of T7, unchanged. No areas of high-grade spinal canal or neuroforaminal stenosis are appreciated.Lumbar:The conus and cauda equina are within normal limits. The conus tip terminates at the upper margin of L2 which is normal limits.Vertebral body heights are normal. Bone marrow signal is benign. Grade 1 retrolisthesis of L4 relative to L5 is again seen. Alignment is otherwise unremarkable. Edematous endplate marrow signal changes at L5-S1 are again noted. Disc desiccation at L3-L4, L4-L5, and L5-S1 is again seen with particular loss of disc height at the L5-S1 level. Individual levels as below: L1-2: No spinal canal stenosis or neuroforaminal narrowing. L2-3: No spinal canal stenosis or neuroforaminal narrowing. L3-4: Facet hypertrophy. Mild bulging disk. No significant spinal canal or neuroforaminal stenosis. No interval changes.L4-5: Facet hypertrophy. Disc bulge. No significant spinal canal stenosis. Mild bilateral foraminal narrowing.L5-S1: Facet hypertrophy. Diffuse disc bulge again seen including involvement of the neural foramina. No significant spinal canal stenosis. Moderate bilateral neural foraminal stenosis.
1. Overall no significant change in size and extent of lower thoracic syrinx with small areas appearing slightly larger or smaller compared to 12/18/2014 as detailed above.2. Significant parenchymal volume loss involving the thoracic cord at the level of the syrinx as well as above it involving the mid thoracic cord. The mid thoracic cord volume loss has mildly progressed when compared to remote MRI from 2009. 3. Degenerative changes in the lumbar spine, worst at L5-S1 where there is up to moderate bilateral neural foraminal stenosis. No significant spinal canal stenosis at any level.