Syrinx, follow-up thoracic disk disease Again seen is a thoracic syrinx extending from the T3-T4 to the T7-T8 levels. Syrinx measures up to 5x5 mm in the axial plane at the T4-T5 level Atrophy of the mid thoracic cord is again noted with cystic myelomalacia at T7-8 involving nearly the full dimension of the thoracic cord . The spinal cord is anteriorly displaced which is at least in part related to exaggerated thoracic kyphosis. There is however focal kinking of the cord at the T6-T7 level where the thoracic cord abuts the ventral thecal sac. Degenerative changes are seen at multiple levels similar to prior with small disk bulges and a relatively more prominent disk protrusion at the left T6-T7 level which indents the left thoracic cord. Smaller disk bulges and small protrusions are seen at the T4-T5, T5-T6, T7-T8, and T8-T9 levels. levels. Posterior thecal sac is widely patent.Vertebral body heights are preserved. Small perineural cysts are again seen in the lower thoracic spine. There is loss of intravertebral disk space at the L1-L2 level with suggestion of ankylosis and mild retrolisthesis. Degenerative changes are also seen in the partially visualized cervical spine including mild anterolisthesis of C4 on C5.
1. Unchanged thoracic syrinx which extends from the T3-T4 to the T7-T8 levels. There is atrophy involving the mid thoracic cord. There is extensive bilateral cord signal abnormality at the T7-T8 level where there is suggestion of cystic myelomalacia. These findings may be related to remote ischemia, inflammation, or other injury.2. Unchanged kinking of the thoracic cord at the T6-T7 level where it abuts the anterior dural surface. Findings may be related to scar tissue however transdural cord herniation cannot be excluded. 3. Degenerative changes including left paracentral disk protrusion at the T6-T7 level which indents the thoracic cord again noted. Posterior thecal sac is widely patent. Exaggerated thoracic kyphosis again seen.