PMC4325502_01
Axial T1, T2-weighted MRI (left, center) shows significant right ventral shift of the spinal cord and a dorsal midline subarachnoid septum at T5-T6 disc level. The midline septum is observed only at this level. Sagittal T2-weighted MRI (right) shows ventral displacement of the spinal cord at T5-T6 disc level. Focal ventral kinking and adhesion of the spinal cord is apparent with an enlarged dorsal subarachnoid space.
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T5-T6 disc level (Figure 1). The midline septum separated dorsal subarachnoid space at the level, but not cranial nor caudal levels.
Axial CT myelography at the same level as the MRI axial image (Figure 1) shows no pooling of contrast medium ventrally to the spinal cord, an uninterrupted flow of contrast material and no filling defect.
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As for dorsal side of spinal cord, it also showed an uninterrupted flow of contrast material and no filling defect (Figure 2).
Intraoperative photographs. The upper photograph shows the dorsal subarachnoid septum (arrows). Right side is cranial. The lower photograph indicates the vessels in the septum (arrows).
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It connected the dorsal dura mater to the dorsal surface of the spinal cord (Figure 3), it is not a normal arachnoid trabeculation which is usually seen in the thoracic spine.
Axial T1, T2-weighted MRI (left, center), sagittal T2-weighted MRI (right). The focal mildly high T2 intensity in the cord (arrows) was believed to be due to regional edema, gliosis or postoperative effects.
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A half year later, the spinal cord remained reduced on postoperative MRI (Figure 4).