Left thoracic curve scoliosis. Assess for spinal cord abnormalities. The patient did move during the examination. This have limited the ability to cross reference the images and findings between different planes. Also, the patient did refuse to complete the lumbar part of the examination. Therefore, a tethering lesion of the cord cannot be ruled out with confidence.Cervical Spine:Alignment is anatomic. Vertebral bodies are preserved in height and morphology. There is no significant marrow abnormality. The intervertebral discs are preserved in height. The spinal canal is preserved. The spinal cord shows normal morphology and signal. Included brain shows no significant abnormality. Included cervical soft tissues show no signal abnormality. Lymph nodes in the upper neck on both sides are nonspecific but likely reactive.C2-C3: There is no spinal canal or foraminal stenosis.C3-C4: There is no spinal canal or foraminal stenosis.C4-C5: There is no spinal canal or foraminal stenosis.C5-C6: There is no spinal canal or foraminal stenosis.C6-C7: There is no spinal canal or foraminal stenosis.C7-T1: There is no spinal canal or foraminal stenosis.Thoracic Spine:There is a broad-based, leftward convex curvature centered in the lower thoracic spine (T9/T10). There is a well-circumscribed, fluid-intensity (but no contrast was administered) structure that occupies and expands the right T10-T11 neural foramen and extends medially into the epidural space mildly displacing the thecal sac and spinal cord the left. However, the cord shows normal signal characteristics. Also, there is still a thin rim of fluid/subarachnoid space around the cord. This is also associated with mild scalloping of the posterior vertebral body on the right as well as thinning of the right pedicle. There is no associated marrow edema. The remainder of the thoracic spine shows preserved vertebral morphology, marrow signal and no significant degenerative disease.There is no spinal canal or foraminal stenosis, otherwise.
1.Limited examination; because of patient's motion and inability to complete the examination as described above.2.Leftward convex curvature in the lower thoracic spine without congenital, morphologic abnormality of the thoracic spine. 3.There is a cystlike structure involving the right T10-T11 neural foramen with medial extension into the epidural space causing mild mass effect on the thecal sac and spinal cord. This also causes smooth osseous scalloping without edema. This may represent an arachnoid cysts or a perineural root cyst with epidural extension but then the relationship to the scoliosis would be more difficult to explain as these are not usually associated with scoliosis unless there compression of the nerve root (are there radicular symptoms related to the right T10 nerve root?). Contrast myelography might provide additional information (regarding wall permeability) of these lesions. While a nerve sheath tumor would be difficult to reliably exclude without intravenous contrast, it seems unlikely given the signal characteristics of the lesion. This is a consideration otherwise, a contrast-enhanced examination is needed. A small lateral thoracic meningocele is an even less likely consideration unless the patient has neurofibromatosis type I.4.Cervical spine is normal. Small lymph nodes in the upper neck are nonspecific.5.The lack of lumbar spine imaging does not allow for reliable exclusion of cord tethering.