Female, 59 years old, syrinx, history of tethering and spina bifida Extensive postoperative findings are again seen in the lumbar spine related to lipomyelomeningocele repair and cord detethering. Mild syringohydromyelia of the distal spinal cord spanning from approximately T12 to L2 is unchanged in caliber and extent. At its widest point it measures approximately 5 x 3 mm. Cord parenchymal volume loss is also noted.The distal spinal cord remains closely apposed to the posterior aspect of the spinal canal. No change in distal cord position is seen on prone imaging although there is ventral motion of the lower thoracic cord.The distal lumbar spinal canal is ectatic with septations in the thecal sac as seen before. Partial nonsegmentation of the posterior aspects of the L4 and L5 vertebral bodies is again seen. Dysplastic posterior elements again seen.There is prominence of the thoracic kyphosis and lumbar lordosis which can be better assessed with standing radiographs. Vertebral body heights are preserved. No marrow replacement or marrow edema is detected. Again seen are mild multilevel degenerative changes. There is a new disc extrusion at the T10-T11 level with partial effacement of the ventral thecal sac, but no significant stenosis overall at this level. Small left paracentral disc extrusion at T12-L1 and small protrusion at T11-T12 not significantly changed.Again seen is marked fatty atrophy of the lower lumbar paraspinal musculature. Small left renal cysts again seen.
1. Postoperative changes related to lipomyelomeningocele repair and cord untethering. There is no significant change in small syrinx involving the distal spinal cord. No significant change in position of the distal cord which does not demonstrate ventral motion on the prone sequence and may represent re-tethering in the appropriate clinical setting. Distal thoracic cord does demonstrate ventral motion on the prone sequences.2. Mild multilevel degenerative changes are again seen with a new T10-T11 disc extrusion without significant mass effect