Bilateral Facet Hypertrophy

[dustybrown]

I first placed this in the Arthritis community because I wasn't sure where to put it because it is an arthritis topic, yet I am not getting any responses, so I thought I'd post here too. I was recently diagnosed through an MRI with bilateral facet hypertrophy in my lower back at L5-S1 and L3-5. Also degenerative facet disease along with a disc bulge and a tear. I had a previous MRI two years ago which claimed I had scoliosis, but never mentioned the facet problem. I am wondering, is the hypertrophy arthritis or stenosis? It says somewhere else on the report that I have no canal stenosis, but I also have an EMG to prove that I have some minor nerve damage, which causes foot numbness??? I am very confused. Does anyone know the correct definition of hypertrophy? Thanks in advance.

[danssweetheartdetroit]

Dear Dr Vinod: My husband was hurt at work. They made him complete 6 weeks of PT before they would do an MRI. The entire time my husband in raging pain saying that PT was making him worse. He is 46, and never has even taken a Tylenol for pain, who know relies on (2) 10-325 hydromorphone,4 -5 times daily and flexeril. The accident was in Dec, he just had his MRI last week. T12-L1: unremarkable, L1-L2 unremarkable, L2-L3: Mild disc bulge and mild bilateral facet hypertrophy with mild central canal stenosis and mild bilateral foraminal encroachment. L3-L4: Diffuse disc bulge and bilateral facet hypertrophy with moderate central canal stenosis and mild right and moderate left foraminal narrowing. L4-L5: Diffuse disc bulge with posterior annular fissure, and bilateral facet and ligamentum flavum hypertrophy causing moderate central canal stenosis and mild right and moderate left foraminal narrowing. L5-S1: Mild bilateral facet hypertrophy. No foraminal or canal stenosis. Also the MRI states he has DDD. His workmans comp has denied epidurals to help the pain and get him back on his feet siting that they are not necessary. We are at a loss and not sure where to turn.

[rfev]

When you wrote in 2010, did you get some type of answer.  I am not finding it and I have MRI's that read very similar to yours.

[mueller89]

I just got an MRI done, i am 24 yr old male and in the Marines.  It states

L5-S1: There is mild, bilateral facet joint hypertrophy. There is relatively decreased disk heightwithout disk herniation, central, lateral or foraminal stenosis. Relatively diminutive disk height at this leavel is most likely congenital given lasck of herniation or desiccation.

Could you help me understand this

[richard04401]

want is diffuse disk bulging? want is degenerative facet hyperophy? want is widely patent spinal canal? want is degenerative changes in the facet joint? want is neural foraminal?
bilateral degenerative facet hypertrophy

[jill1205]

Maybe you can answer my question. I am age 51, female. The 2 impressions that stick out on my Lumbar MRI are Severe bilateral facet hypertrophy L4-5 w/joint effusions within the facet joints and also severe facet arthrosis L4-5. In the past year, I have had pretty severe pain at time, mostly on the right low back going into the right hip area and right thigh.
Is this something that is ever going to get better? Is there anyway to fix this? Could surgery repair this? Otherwise, I hate to think what I will be like at 70......I don't know if I would be able to walk. Just curious on hearing another opinion.....

[oogiemazook]

I'm an extremely active 56 year old male who had foot surgery to remove a bone spur. The rehab required that I lay flat for one week and wear a boot on my right foot for approximately 3 weeks. This resulted in severe pain in my lower back,pain,numbness and tingling in my right thigh and calf and numbness and tingling in my right foot. My ortho said it was sciatica and it would resolve. After 3 weeks of exquisite pain,an MRI was done on my lumbar spine.
"Impression:POSTERIOR DISC BULGES OF 3-4MM AT THE NARROWED L1-2 LEVEL. 3MM AT L2-3,4MMAT L3-4 AND 5MM AT THE NARROWED L3-4 LEVEL AS WELL AS 2-3MM AT L5-S1 WITH CENTRAL CANAL NARROWING THAT IS MILD FROM L1-2 TO L3-4 AND SEVERE AT L4-5
FACET HYPERTROPHY WHICH IS BILATERALLY MODERATE AT BOTH L1-2,BILATERALLY SEVERE AT L4-5 AND AT L5-S1 MILD ON THE LEFT AND SEVERE ON THE RIGHT
NEURAL FORAMINAL NARROWING WHICH IS BILATERALLY MILD AT BOTH L1-2 AND L3-4,SLIGHT ON THE LEFT AND MILD TO MODERATE ON THE RIGHT AT L2-3,AND AT L4-5 MODERATE ON THE LEFT AND MILD ON THE RIGHT
Now I realize this isn't good. I've had problems with my back for years due to a fusion of one vertebrae to my sacrum. I think that's what somebody said. What I'd like to know Dr. Vinod is should I continue playing racquetball three times a week and lifting weights(moderately) 3 times a week. Like I said I'm in great shape and very active and I'm rather surprised that my back is so bad. I was absolutely feeling great right up until I had to have the foot surgery,whcih was do to my active lifestyle. I will not have surgery.I can tolerate large amounts of pain,even though I really can't take anything for it. I'm severely allergic to all NSAIDs. Lastly,when should I consider surgery? Every single person I've ever spoken to about lower back surgery has had nothing but bad things to say,even two of my orthopedic surgeons. One gave it a grade D.
I would really appreciate your opinion. Thank you in advance

Ed

[marilb69]

I had an accident at work were I fell the stairs two years ago. The MRI, at that time diagnosed two herniated discs and one disc bulge at L3-4, L4-5, and L5-S1 level with lumbar stenosis.  Since then I've had conservative treatments like: chiropractor, acupuncture, physical therapy, and lumbar blocks monthly for one year 'til date. The last MRI, May 2010, indicate3s mild leftward curvature of the lumbar spine, L4-5 degenerative disc disease associated with disc bulge with facet hypertrophy resulting in moderate narrowing of the neural foramina, and L5-S1 bilateral facet hypertrophy. At the moment, the doctors are consulting each other what alternative is better for me right now because they don't understand why I have such a excruciating chronic back pain, I'm in a wheelchair 'cause I feel numbness of the legs, decreased mobility, and the legs tremble whenever I try to walk a few steps (I've fell several times doing so). I need to know if: there's another treatment for this diagnosis?

[Dr Vinod]

Surgery is the final option.
Try everything to avoid surgery and to delay it presently.

Take the instructions of your Rheumatologist and try following them and it might work.
Take care!

[dustybrown]

Thank you so much. That's what I was thinking, but I was getting really confused because it seems as though Facet Hypertrophy and Stenosis seem to go hand and hand- at least in later stages. Perhaps this is what I have to look forward to. It seems like my spinal issues are deteriorating quite rapidly for my age. I saw a Neurosurgeon a couple of years ago with an earlier MRI from 2007 (before the facet arthritis diagnosis in my 2009 MRI) and he said he didn't think I needed any surgery, but probably some kind of pain management would be in order because I am in an awful lot of pain and the numbness is hard to deal with sometimes. I now see a Rhuematologist actually, so I am sure if she was really worried about it getting to that point she would refer me somewhere.  Thanks again for your help.

[Dr Vinod]

Your spine consists of bone and discs. The bony parts are called facets, which are connected to each other at joints, called facet joints. Facet joints are on the left and right side of each facet.

You have bilateral facet hypertrophy. This basically means you have enlarged facet joints at the level you mentioned on both sides at that level. This is considered chronic inflammation in this area.

Basically, your spinal joints have worn out a little bit. Facets are the rear part of your spine, where the joints meet. Hypertrophy means growth. Basically, arthritis in the spine.

You need to follow up near an orth   opaedician or a neurosurgeon.