Female, 48 years old, history of coccygeal/sacral chordoma status post resection. Surveillance scan. The previously demonstrated postsurgical changes are minimally included on this examination and this region is better assessed on the accompanying pelvic MRI.Fatty signal within the S2 and S3 vertebral bodies is again seen similar to prior compatible with focal fat or hemangiomas. No evidence of suspicious T2 hyperintensity or pathologic enhancement is seen at these levels.Elsewhere in the lumbar spine, no pathologic marrow signal alteration or enhancement is seen. Vertebral body height and morphology is normal. The visualized spinal cord, conus and cauda equina are unremarkable. Conus medullaris terminates at the L1-2 level.L1-2: No significant disc disease. No spinal canal or neural foramina stenosis.L2-3: No significant disc disease. No spinal canal or neural foramina stenosis.L3-4: Disc abnormality has improved with minimal residual disc bulge and increased conspicuity of central annular fissure. No significant spinal canal stenosis. No significant neural foraminal narrowing. L4-5: Mild disc bulge, which has slightly worsened, indenting the ventral thecal sac. Left dorsal annular fissure is now only barely seen on this examination. Mild bilateral foraminal narrowing.L5-S1: Left paracentral disc protrusion has decreased in size decreased posterior displacement of the descending left S1 nerve root. No significant central canal stenosis or neural foraminal stenosis. There is now a left paracentral annular fissure.Mild facet arthropathy in the lumbar spine. Paraspinous soft tissues are unremarkable.
1. Postsurgical changes in the sacrococcygeal region are almost completely excluded from this examination. No evidence of residual or recurrent tumor is seen. Please see separate report from accompanying pelvic MRI.2. Mild degenerative changes in the lumbar spine as described above with fluctuating disease, including improvement especially of the disc protrusion at L5-S1 and associated mass effect on the left S1 nerve root.