Reason: r/o worsening of syringomyelia History: L sided insensate to sharp. Limited exam of the complete spine. Cord compression protocol images obtained.Cervical:Patient is status post Chiari decompression, with postoperative changes including removal of the posterior arch of C1 and expansion of the adjacent thecal sac. This appears unchanged compared to prior exam. The intracranial stent is again visualized, traversing the fourth ventricle with its tip terminating likely within the superior fourth ventricle, unchanged in position. Images through supratentorial space demonstrate normal size of the supratentorial ventricular system and with maintained midline similar to prior exam. There is no evidence of spinal cord compression. There is diffuse increased T2 signal intensity of the dorsal aspect of the cervico-medullary junction, with more discrete central canal prominence extending inferiorly through the entire cervical and thoracic spinal cord. Full evaluation of the extent and size of this syringohydromyelia is limited by cord compression technique. There is unchanged tenting of the cervical medullary junction of the cord posteriorly, likely representing spinal cord tethering at this site.
1. No evidence of spinal cord compression.2. Status-post Chiari decompression, with stable postoperative changes as described above.3. Syringohydromyelia is redemonstrated throughout the cervical and thoracic spinal cord, however is incompletely evaluated by this limited study. If there is persistent clinical concern, a dedicated complete spine MRI should be obtained to further evaluate the spinal cord.