Hello You are right in asking the question. The radiological report does indicate a status in which many physicians advise surgery and many patients get operated upon. However, the decision of surgery is not made completely upon the imaging findings. The clinical history and examination findings are the foremost things a physician keeps in mind. A patient with neurological deficits, like weakness of hands or feet, constipation, urinary complaints etc., is usually advised surgery straightaway. But patients who come only with pain and no compression of the spinal cord on MRI, are put on physiotherapy and medications first. Only if this conservative line of management fails, then surgery is advised. Most patients who comply well with the conservative line management are able to delay surgery for a significant period of time, or even totally prevent the need of surgery sometimes. Hope this solves you query... But remember, the physician who has seen you and examined you is usually the best judge... Take care...