Male, 41 years old, with history of medulloblastoma presenting with worsening back pain and lower extremity weakness. Cervical:Postoperative findings are demonstrated in the posterior fossa including evidence of suboccipital craniotomy, encephalomalacia of the cerebellum and prominence of the fourth ventricle. A small pseudomeningocele in the posterior midline operative bed is unchanged measuring up to 7 mm in thickness.The visualized spinal cord demonstrates normal signal intensity and morphology. No evidence of pathologic intracanalicular enhancement is seen.Spinal alignment is anatomic. Vertebral body morphology and signal characteristics are within normal limits. Minimal disk bulging at C6-7 is seen. Otherwise, no evidence of significant degenerative disk disease, spinal canal stenosis or neuroforaminal narrowing is detected.Thoracic:The visualized spinal cord demonstrates normal signal intensity and morphology. No evidence of pathologic intracanalicular enhancement is seen.As before, a T2 hyperintense oval structure along the left second rib is unchanged and may represent a nerve root sleeve cyst or schwannoma.Spinal alignment is anatomic. Vertebral body morphology and signal characteristics are within normal limits. Small paracentral protrusions are redemonstrated on the left T6-7, bilaterally at T7-8 and on the right at T9-10, unchanged. No significant spinal canal or neuroforaminal stenosis is demonstrated.Lumbar:The conus and cauda equina are unremarkable. No pathologic intracanalicular enhancement is seen.Grade 1 anterolisthesis of L5 relative to S1, and bilateral L5 pars interarticularis defects, are redemonstrated. Otherwise, vertebral body morphology and signal characteristics are within normal limits. Disk uncovering and disk bulging at L5-S1 is unchanged. No significant spinal canal stenosis is seen. The L5-S1 neural foramen are mildly narrowed.
1. No evidence of metastatic disease in the spine.2. No significant spinal canal stenosis or other findings are seen which would account for the patient's symptoms.