Originally Posted by Bipe Flyer

My most recent visit to an Orthopedic Surgeon ended with him leaving the decision for an ACDF up to me. He basically said that when I could no longer tolerate the pain, come back and we'd schedule surgery. I just got copies of the most recent Cervical MRI report and Nerve Conduction study that led to that visit. Here are the significant findings:
MRI:
General: Normal Cervical Lordosis. No fractures. Diffuse DDD and facet arthropathy, most prominent and moderate to severe in nature at C5-C6. Small Schmorl's node superior endplate of T2 is unchanged. Minimal anterior wedging of T2 vertebral body is unchanged.
Specific:
C2-3: Mild DDD. No canal stenosis Mild facet arthropathy. No Foraminal narrowing
C3-4: Mild DDD w/mild posterior disc bulging and 2mm central disc protrusion which exhibits slight mass effect on the thecal sac but does not touch the cord. Mild posterior ligamentous hypertrophy resulting in mild canal narrowing measuring 10mm in AP diameter. Mild to moderate bilateral facet arthropathy and mild to moderate bilateral foraminal narrowing.
C4-5: Mild DDD. mild diffuse disc bulging and endplate spurring with a 2-3mm central broad-based disc protrusion. Mild posterior ligamentous hypertrophy and facet arthropathy results in moderate canal stenosis measuring 7-8 mm in AP diameter. Moderate bilateral foraminal stenosis.
C5-6: Severe DDD. Diffuse posterior osteophyte complex, moderate to severe facet arthropathy and moderate posterior ligamentous hypertrophy. Severe canal stenosis with obliteration of surrounding CSF signal and resultant mass effect upon the cervical cord. The canal measures 5-6 mm in AP diameter. There is no underlying cord edema or myelomalacia.
C6-7: Moderate DDD. diffuse posterior disc osteophyte complex an posterior ligamentous hypertrophy. There is severe resultant canal stenosis measuring 6-7 mm in AP diameter. There is obliteration of the CSF signal surrounding the the cord and there is mass effect upon the cord without underlying cord edema or myelomalacia. Moderate to severe bilateral foraminal narrowing.
C7-T1: Canal is of fairly normal caliber. There is minimal posterior disc bulging and mild posterior ligamentous hypertrophy. Moderate facet arthropathy and foraminal narrowing.
T1-2: Normal
T2-3: Interval increase in central-left paracentral disc protrusion measuring 3-4 mm in AP diameter which exhibits slight mass effect upon the left ventral aspect of the thoracic cord. Mild to moderate left-sided foraminal stenosis and mild right-sided foraminal narrowing. Small right foraminal disc protrusion.
T3-4: 3mm central-right paracentral disc protrusion which touches the cord without displacement. Increased since prior study.

The nerve test showed moderate to severe chronic bilateral C6 and C7 radiculopathies, and could not rule out C8 nerve root involvement. There was no evidence of generalized peripheral neuropathy.

I have about a thousand questions, but will limit myself to the most pressing for now.
I'm as much concerned abot the resulting nerve damage as I am about pain. What should be my determining factor in deciding when to have surgery? Notice I said "when" not "if".
Will an ACDF actually reduce the pain? I presume the Doc meant C5-6 and C6-7.
As you can probably tell, I'm a mess all the way up and down my spine. How will the "ladder effect" come into play:?

Thanks in advance for your opinions.