There are important meanings to all these descriptions in the "IMPRESSION" section. Impression is the radiologist's medical diagnosis so the referring physician can make a definitive diagnosis and treatment plan. Your doctor should still develop a treatment plan for you. It's just complex with so many things going on. It may not be that you're not a surgical candidate absent other things, it may be more like "in your case" it may cause more problems with your other conditions or they're not sure (right now your doctor probably is not sure) what level of your spine to try to fix first. when you're complicated like you are, conservative may be your best bet. My first pain management visit my doctor said I would be like an onion. I would have to peel off one layer at a time. seems he was right about that too. just takes a long time. At one time, even if I had opted for the TOS surgeries, my lower back was so bad I couldn't lay in a bed for more than 20 or 30 minutes. had to move to another position. so that would have been really painful, actually almost impossible without being knocked out. it turned out I wasn't wrong about that either (referring to an outpatient surgical event-minor-but back gave me a lot of problems - not the surgery on my ear, but my back - actually caused an unsuccessful or not as successful of a surgery-and at the least caused me a lot of pain and suffering. outpatient surgery was a breeze-back pain is miserable pain.