A 48-year-old male asked:
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what is the prognosis for lumbar stenosis with bulging discs at l4/l5 and l3/l4 with spinal cord effacement and bilateral facet joint hypertrophy.

3 doctor answers
Dr. Scott Smith
29 years experience Orthopedic Surgery
Depends: : Can be very problematic with leg and back pain requiring treatment. It is almost normal for all human beings to have some l5/s1 and l4/l5 facet arthritis and disc disease. Rarely requires treatment more than core exercises, nsaids, back rehab and other conservative/ fitness training.
Answered on May 19, 2016
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Dr. Lisa Rankin
Dr. Lisa Rankin commented
24 years experience ADHD and Autism
Avoid the use of narcotic pain meds as much as possible as you may alter the way your body responds to pain and will not see the benefit from the therapeutic interventions. If there are no objective neurologic findings like weakness or significantly abnormal nerve conduction tolerating some pain in the beginning can save years of dealing with pain meds.
Mar 24, 2013
Dr. Roger Frankel
28 years experience Neurosurgery
Mixed: Facet hypertrophy is a common change as people age; the amount of joint enlargement is more important than the fact that it is present. Stenosis is an issue if it is symptomatic. Weight control and exercise can help. Surgery can help in cases that don't respond to other treatment. The spinal cord usually ends at l1-2, so if it truly goes down to l5, there are other issues that need to be addressed.
Answered on Mar 18, 2016
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Dr. Thomas Dowling
39 years experience Orthopedic Spine Surgery
The majority of : People are treated non operatively with spinal stenosis which is generally due to diffuse aging of the spine with the facet joints overgrowing and the discs degenerating and bulging as they collapse . About 15% improve with time, 15% get worse & the rest remain as they are. Of those that go to surgery, most do well until about 5 years postop, with some regressing do to further degeneration.
Answered on May 9, 2020
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