This is regarding my father in law. He is suffering from back pain since 2006. His mri report says. Grade second anterolisthesis of l4 and l5, diffuse disc bulge at l2 3 and 3,4 indenting the thecal sac and causing crowding of cauda equina nerve roots with bilateral neural foramina compromise without any nerve root compression, diffuse disc bulge at l4 &5, causing bilateral neural foramina compromise with compression of bilateral l4 exiting nerve roots with spinal canal stenosis, degenerative disease with limbo sacral spine. Please advice if we can opt for surgery or physiotherapy. He is 77 year old. Quick response will be highly appreciated.