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Old 02-28-2012, 03:39 PM   #1
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Question New to this...

I had a head on accident in 1987 that broke some ribs and caused a concussion. No back injury was noted at that time but months later I started having issues that I addressed with a chiropractor and seemed to be doing better. Until 1993 when I delivered my daughter, herniating my L4-5disk (she's been a pain in my a@# ever since...just kidding.) I had surgery for a herniated disk 2 months Krystara's birth. Within a few years I had a second surgery for the same issue. Then in 2009 I ended up needing a fusion of L4-5. Now, in 2012 I have been experiencing pain in my lower back for the last 4-5 months. I've recently gone for an updated MRI and here are the results:

"Extensive facet arthropathy at L4-5 and the 2 levels above and at L5-S1 There is mild left foraminal compromise at L5-S1 and mild subarticular stenosis at L4-5 greater on the right."

Can anyone tell me what this means in english?

 
Old 02-28-2012, 06:14 PM   #2
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Re: New to this...

Welcome to the board. Unfortunately, you are probably reaping the delayed consequences of the accident you had many years ago. My father was in a near fatal crash when I was 16. In the process of settling the insurance claims, several different doctors told him that with any high impact event like an automobile accident most people develop arthritis throughout their bodies in future years.

Your findings indicate [B]Extensive facet arthropathy at L4-5 and the 2 levels above and at L5-S1 [/B]. Facet arthropathy is a fancy description of degenerative arthritis at the facet joints. The facet joints are synovial joints that are located in pairs and connect the posterior vertebral elements.
They are what allow the spine to bend, twist and have some movement. Often the degenerative process includes the development of bone spurs and thickening of ligaments, etc..

As the joints enlarge, they can take up room that is needed by the spinal nerves. This can result in nerve pain that can radiate out to the limb.

This same process of something enlarging and taking up space that is needed for nerves to pass freely is what is reported in the rest of your MRI report.

[B]There is mild left foraminal compromise at L5-S1 and mild subarticular stenosis at L4-5 greater on the right."[/B]

The foramen are the openings through which the spinal nerve must pass as it exits the spine. It can become blocked from something like a disc herniation, or an enlarged facet. In this case, at the L5-S1 foraminal opening on the left side, there is MILD blockage. (these types of things are graded as follows: minimal, mild, moderate and severe). Depending on how much space still remains, this might be a source of pain.

And, finally there is some stenosis (narrowing) in the right subarticular region at the L4-L5 region. Subarticular is the region under the facet joints where the nerves run as they exit the spine....so due to the facet arthropathy there is less room for the nerve to pass and the area through which it must travel is more narrow than it should be. (I always "picture" stenosis by thinking of an old metal pipe that is badly corroded with mineral deposits. When it was new, water passed freely, but through the years, the pipe got filled up with "gunk" to the point that water is barely trickling through. ) In order to make more space for the nerves, sometimes the doctor will go in and, just like a plumber, clean out all the "gunk" to make more room for the nerves so they can pass freely again. This can relieve nerve pain. But again, this stenosis is rated as MILD and it is on the right side.

Now this is my layman's understanding of the language of your report. Please see your doctor for what all this means to you, and what plan of treat is appropriate for you since you already have the fusion at l4-L5.

Good luck and let us know how you are doing.

Last edited by teteri66; 02-28-2012 at 06:21 PM.

 
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Old 02-28-2012, 09:26 PM   #3
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Re: New to this...

Thank you so much for the explanation. It is much easier for me to grasp now that you've put it this way. I have an appointment on March 8th with my orthopedic surgeon. We'll see what he has in store for me.

 
Old 02-29-2012, 07:42 AM   #4
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Re: New to this...

If you look up spinal anatomy and find an illustration, it will be much easier to understand where the facets are located, how they "link" the adjoining vertebrae, etc.

I hope your doctor will have some good plan of treatment for you that will provide some relief from your pain.

 
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