Mild bilateral foraminal stenosis at L4 - 5?

Answer 1

A foramen is a hole.  Stenosis is a narrowing of that hole.  Your spine is made up of bones called vertebrae that are named by their region (cervical, thoracic, & lumbar - C, T, & L) & the number from the top.  L4 & L5 are the 4th & 5th lumbar vertebrae, & they are the lowest vertebrae in the spine.  L4 & L5 come together and form a hole on each side (right and left) that is called a neural foramen.  Out of that neural foramen comes your right and left L4 nerve.  If there is foraminal stenosis at the bilateral L4-5 foramina, then you may be encroaching upon or pinching those right and left L4 nerves.

Answer 2

Your radiology report is basically saying that you've got a small bulge (herniation) at the disk between the 4th and 5th lumbar vertebrae (the most common problem area for most people, including myself) at the back (posterior) of the disk. The foramina are the holes/spaces between the vertebrae in which the nerves pass, and it's saying you've got mild narrowing of those areas at those vertebrae. This is common in people with spinal problems, but most people get some narrowing as they get older. It's the degree of narrowing that doctors focus on.

Posterior herniations, though they can be painful (mostly from muscle spasms) aren't as bad as anterior hernations, which press on the nerves closest to the spine and spinal cord, causing pain which you never want to experience.

Regardless of how small the herniation is, the short and long term treatment is typically the same:

Short Term

Stay off your feet, reduce any sitting (both increase pressure on the lower spine).

Lay down with a pillow/cushion between your legs, big enough so that the legs are parallel to each other. This takes pressure off the hips, and the spine.

Take anti-inflammatories, muscle relaxers, etc., to keep inflammation and spasms down.

Long Term

Once you've herniated a disk, it will eventually heal; however, there will always be a weak spot in the disk membrane at that point. The only thing you can do is to work on preventing it from happening again. Refrain from lifting heavy objects, don't sleep on your back or stomach, but your side. If you have to sleep on your back, raise your legs with a cushion to get pressure off the lower spine.

Do your best to start a good stretching program (by good, I mean more than a few minutes). Anything less than 30 minutes isn't worth much. Toning the back and stomach muscles also helps.

Two OTC meds I use regularly (on top of opiates) is Tylenol Extra-Strength Rapid Release Gel-Tabs, and Bayer Back & Body Aspirin. Both work fast and are pretty effective. I often use them when I don't feel the need for Percocet.

Answer 3

Between the 4th and 5th lumbar vertebrae, the ligaments that hold together the vertebrae have grown larger over time due to wear and ear. As a result, your spinal cord and the nerves that come off it at that level have less room.

Answer 4

I have bilatera neural foraminal stenosis. Will surgery be necessary?

Answer 5

Holes are narrowing on both sides all the way up