Question: I had a spinal fusion L5-S1 34 yrs ago. Starting getting pain in the last 6 months - MRI shows "At L5-S1 there is uncovering of the posterior disc and severe bilateral facet hypertrophy. Findings result in moderate right neural foramen, no central canal, and mild left neural foramen narrowing. There is probable mass effect upon the exiting right L5 nerve root. There is probable hemisacralization of the left L5-S1 articulation.

What does all that mean?

Thank you - - I was focused on the L5-S1 because that is where my fusion is - but there appears to be further degeneration above the fusion site - there is also a 7mm synovial cyst.
Re 34 years - not to say I haven't had any pain over the years - I just manage it through chiropractic adjustment and trying to maintain a good weight w/core strengthening exercises like Pilates. However, the pain in last 6 - 9 months is becoming debilitating on some days. Below is the entirety of the report - please let me know if you have additional thoughts.

There is grade 1 anterolisthesis of L5 on S1 with probable spondylolysis although pars interarticularis defects are not definitively visualized. There is mild apex left scoliosis. The vertebral body heights are preserved. A small multilevel ossific spurring. Trace edematous endplate changes are noted at L1-L2, L2-L3, and L5-S1.
There are no destructive marrow lesions. There is mild marrow edema involving the left L4 and L5 pedicles extending to involve the left L4-L5 facet articulation most suggestive of stress reaction. The partially visualized paravertebral soft tissues are grossly unremarkable. The conus terminates normally at L1. The visualized thecal sac is unremarkable.
There is moderate multilevel degenerative disease involving lumbar spine, most prominent at L1-L2 and L5-S1. Though not tailored to assess the thoracic spine, the visualized portions of the thoracic spine is a small to moderate degenerative changes. At T12-L1 there is a left paracentral disc protrusion which results in no right neural foramen, mild left central canal, and mild left neural foramen narrowing. At L1-2, there is no posterior disc contour abnormality. There is no facet arthropathy or ligamentum flavum hypertrophy. There is no central canal or neural foramen narrowing. At L2-3, there is no posterior disc contour abnormality. There is no facet arthropathy or ligamentum flavum hypertrophy. There is no central canal or neural foramen narrowing. At L3-4, there is no posterior disc contour abnormality. There is no facet arthropathy or ligamentum flavum hypertrophy.
There is no central canal or neural foramen narrowing. At L4-5, there is flattening of the posterior disc and moderate bilateral facet hypertrophy without significant central canal or neural foramen narrowing. At L5-S1, there is uncovering of the posterior disc and severe bilateral facet hypertrophy. Findings result in moderate right neural foramen, no central canal, and mild left neural foramen narrowing. There is probable mild mass effect upon the exiting right L5 nerve root. There is probable hemisacralization of the left L5-S1 articulation. On image 7 of series 5, there is a probable 7 mm synovial cyst projecting actually from left facet articulation which results in partial effacement of the left lateral recess.

Thank you very much. I have an appointment with an orthopedic specialist today, and I'm glad to have more knowledge going into the appointment. I'm not a fan of steroidal injections into the spine - so lumbar fortress, NSAID and building a strong core is my focus!