Male, 56 years old, status post resection of the spinal lesion in 1985, with back pain and evidence of a spinal lesion on prior MRI. Three-month follow-up exam. Thoracic:Evidence of prior surgery seen including laminectomy from T8 through T10.Interval evolution of the abnormal extradural soft tissue process is seen within the laminectomy defect. This tissue has become somewhat less protuberant towards the spinal canal, now measuring up to 5 mm in thickness, previously up to 8 mm. The signal intensity of this tissue has also evolved. It now appears hyperintense on both T1 and T2 weighted images whereas previously it was T1 hyperintense and T2 hypointense. The rim of this tissue may be enhancing, but the internal components are intrinsically T1 bright and not definitely enhancing.As before, the spinal cord is deformed and tethered to the dura through this region without significant interval change.Elsewhere in the thoracic spine, the spinal cord demonstrates normal signal intensity and morphology. Spinal alignment is anatomic and vertebral body height and morphology are within normal limits. No significant disc bulge or disc herniation is seen. No significant compromise spinal canal or neural foramina is noted.Lumbar:Alignment is anatomic. Vertebral body height and morphology are within normal limits. No concerning marrow replacement or edema is seen. No pathologic enhancement is detected. The distal spinal cord, conus and nerve roots of the cauda equina are unremarkable. Mild degenerative disc disease is seen at L3-4 and L5-S1 with mild disc bulging. The right L3-4 neural foramen is mildly narrowed. Otherwise, no significant spinal canal or foraminal stenosis is seen. Facet arthropathy is also evident at lower lumbar levels. No interval changes are detected.
1.Abnormal soft tissue is redemonstrated within the extradural space of the laminectomy bed from T8 through T10. Given the signal characteristics and interval changes in imaging characteristics of this process, evolving hematoma with perhaps some granulation tissue is favored as the etiology. No clear evidence of an enhancing tumor is seen.2.The spinal cord through this region remains deformed and tethered to the dura, similar to the prior examination. Elsewhere, the spinal cord is unremarkable.3.No other significant findings are seen in the thoracic or lumbar spine.