I'm usually pretty good at going over the MRI's, but this one is right on the line. Since the spinal cord is involved in a couple of areas, I'm just not sure what a surgeon would do. It doesn't seem to be "impinged" but it's being flattened and/or abutted. Either way it's not good.
Therapy MIGHT help -- I just don't know. But knowing how surgeons work, they would UNDOUBTEDLY recommend surgery just because that's their way. They ALWAYS recommend surgery.

It's up to the patient to decide if surgery should be done or not, and that's not the way it should be. Very rarely to you find a surgeon who will tell you to "go to therapy" and see how that works. Most of the time they will "offer" surgery if it's not an emergency, and let the patient make the decision -- or if it's an emergency, they'll TELL you you HAVE to have it.
I really don't know how to advise you on this one. It's borderline as far as I'm concerned. I hope others chime in with their opinions.
if I were you, I would Private message Dubious and see what he has to say. He's excellent in these areas. Best of luck and God bless. Hugs, Lee