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  • daugherty
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    Post count: 1
    #24731 |

    In 2011 I was diganoised with Chiari and syrinomielia. I was decompressed and have been undrer the care of a neurologist since. Most pain is managed simply however we have had a new symptom that he described as Lhermietes like symptoms and requested new MIR’s and for me to return to the neurosurgeon for him to look and the scans. I have my apt scheduled however I would like to know what the wording below means? C4-5 C5-6 and C6-7 levels with some disc osteophyte complex formation and some minimal anterior thecal sac effacement by disc osteophyte complexes. I have posted a copy of the repost below. Any help is appreciated.
    Thank you,
    Stephanie Daugherty

    Excellent appearance of the cervical cord status post occipital craniectomy for decompression of a large cavitary two malformation.

    No acute process. Mild degenerative changes of the cervical spine stable since the prior study.

    Released By: TIM HANES 3/16/2017 1:12 PM

    Narrative

    EXAM: MRI CERVICAL SPINE WITHOUT AND WITH IV CONTRAST

    CLINICAL INDICATION: G95.0 (Syringomyelia and syringobulbia) .

    TECHNIQUE: Multiplanar, multisequence MR imaging of the cervical spine without and with IV administration of14 cc MultiHance.

    COMPARISON: MRI of the cervical spine of degeneration 2015, February 11, 2013 and May 12, 2011

    FINDINGS: The patient shows that since the most recent scan there is been no significant interval change with a persistent small syrinx extending the length of the cervical cord with no interval increase in signal or diameter of the syrinx. The
    improvement since the surgical excisional decompression has been unremarkable, and the cervical cord shows a now nearly normalized volume and contour. The external craniectomy and decompression remain effective, the patient shows some minimal
    degenerative change at the C4-5 C5-6 and C6-7 levels with some disc osteophyte complex formation. The posterior elements are unremarkable. The axial images show normal appearance of the neural foramina, and some minimal anterior thecal sac effacement by
    disc osteophyte complexes as described, with a stable appearance of the central syrinx, which may be slightly improved since the previous study.

    Postcontrast images show no abnormal contrast enhancement.

    Dr. CorenmanDr. Corenman
    Moderator
    Post count: 5036

    It looks like your Chiari decompression surgery was successful. New Lhermitte’s symptoms can be produced by a possible cervical kyphosis due to degenerative discs disease and anterior spurring. This can drape the cord and cause this Lhermitte’s sign with neck flexion. This kyphosis is best seen on standard X-rays with flexion/extension views. The Chiari malformation could also have caused some cord scar and this stretch of the cord could also cause these symptoms.

    Dr. Corenman

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