Question
QUESTION: Would you clarify this MRI report. "L3-L4,the disc is desiccated w/mild disc space narrowing. There is facet disease severe bilaterally incl facet effusion on the right. Posterolateral  ligamentous and bone hypertrophy. Central canal and lateral recess stenosis is severe at this level. There is concentric annular bulge w/extention of annular material into left foramen greater than right. The dominant pathology appears to be acquired canal stenosis." in 2011 I had L4-L5 Interbody Fusion and within 6 mos started a right side limp and growing discomfort / pain down both legs into my feet. Now beginning night pain and fear loss of lower extremities control."

ANSWER: I don't want to be the one to say this, but the use of the word "severe" typically indicates surgery as an option.  Remember, when you had the MRI, you were in a tube on your back, with your knees slightly elevated.  I'd imagine that's the position you LEAST feel pain in, and that's where the problems show as severe.

Facet disease is really just a fancy wording for arthritis in the spine.  

Now, I have written an article on my website to decipher the findings from an MR study, but it's for the cervical spine.  Many of the concepts are the same however, so you should be able to decipher them.  I've also written an article about the lumbar disc.  THey are both boring, but informative as I could make them.

Sorry to be the bearer of bad news for you, but I think it's certainly worth evaluating you for an orthopedic neurosurgical consult.

Cervical Spine
Lumbar Disc

---------- FOLLOW-UP ----------

QUESTION: Thank you. Your quick and frank reply is appreciated. I'm afraid that with a painful ankle (soft tissue and tibia repair 20 years ago and pain beginning after about 6 mos rehab walking following L4-5 fusion) I will not be able to do the 2 miles daily to rehab from a new surgery. Is there other means to rehab ?

Answer
Swimming is almost always the "fallback" exercise:  it is nearly non weightbearing and resistive. It shouldn't flare up your ankle pain and will help maintain your aerobic levels.  But make sure you make the appointment with a ortho sooner than later.  

Please keep me apprised of the results!