Tethered cord, please do tethered cord protocol, status post surgical repair. Muscle spasms. Five lumbar type vertebral bodies are presumed to be present. Again seen are postsurgical changes in the lumbar spine with laminoplasties related to cord detethering. Vertebral body heights are within normal limits. Again seen is dextrocurvature at the thoracolumbar junction and levocurvature of the lower lumbar spine. Evidence of prior spinal hardware with transpedicular screw tracts noted at the L1, L2, and lower thoracic levels. Bone marrow signal is benign. Again seen is a low lying conus with the tip L2-L3 level. Prone images demonstrate no significant ventral motion of the conus and cauda equina nerve roots although scoliosis limits significance of this finding. There is trace increased CSF fluid measuring 2 mm in the AP dimension dorsal to the L1 level (sag prone T2 image 13) as compared to the supine images. Fatty infiltration of the filum terminale is again seen.There is no significant spinal canal or neural foraminal stenosis at any level. Incidentally noted is malformation of the S2 vertebral body with midline cleft.
Postsurgical changes in the lumbar spine related to cord detethering. Again seen is a low-lying conus with tip at the L2-L3 level and fatty filum terminale. Prone images demonstrate minimal if any ventral motion of the conus and cauda equina nerve roots, although patient's scoliosis limits evaluation. Please see details above. Cord re-tethering cannot be excluded and can be considered in the appropriate clinical setting. 