 Assuming 12 rib bearing vertebrae, there appear to be 4 truly lumbar appearing vertebrae. There is suggestion of a segmentation anomaly at L5-S1 without evidence of intervening disk, although there are two sets of posterior elements. For the purposes of this exam, the last fully formed disk is at S1-S2.The lumbar spine is in normal alignment, with significant straightening of the normal lumbar lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. There is abnormal ventral T2 hyperintensity within the distal cord with axial confirmation to the lower T12 level from the tip of the conus, although sagittal images suggest additional abnormality extending cranially although not well delineated. This measures up to 3 x 2 mm at the T12-L1 level. The distal spinal cord and conus are otherwise within normal limits with the conus terminating at the L3-L4 level. There is no evidence of fat signal intensity along the distal thecal sac. On prone imaging, there does appear to be some degree of ventral movement of the distal cord and conus. Under within the thecal sac.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the lumbar spine.
1. Transitional spinal anatomy, incompletely assessed as the counting sequence is not available. For the purposes of this exam, the last fully formed disk is at S1-S2. If surgery is to be contemplated, correlation with imaging of the entire spine is recommended.2. Segmentation anomaly of L5-S1 without intervening disk although with separate posterior elements.3. Utilizing the above counting convention, conus termination is abnormally low at L3-L4 without evidence of a fatty filum. Some degree of ventral motion of the distal cord and conus are noted on the images. Please correlate clinically for tethered cord.4. Small caliber syringohydromyelia within the visualized distal cord extending at least to the lower T12 level is confirmed on axial imaging, although likely also involving additional lower thoracic cord which extends out of the field-of-view. Consider dedicated MRI cervical and thoracic spine as clinically indicated.