Your lower back has a severe deformity (“Severe/grade 4 anterolisthesis of L5 on S1”) which is almost your lumbar spine falling into your pelvis. You do have a bridge of bone protecting you but that may not help as much as it sounds. You have expected foraminal stenosis at this level L5-S1. If you can live with this, you can avoid a significant surgery but you will have to adapt accordingly. You do have osteopenia (soft bone) making surgical correction more difficult.
You don’t have spinal cord signs (“Lower extremity reflexes are normal and symmetric with no long tract signs (babinski or clonus)” and “Bilateral upper extremity reflexes are normal and symmetric with no long tract signs”. You do have gait disturbance but with your large slip at L5-S1, that can be explained.
A C4-7 ACDF might be in your future and be helpful but you have degenerative changes above and below so remember this might not be your last surgery. I would stay away from a corpectomy as I don’t think you need it and they are harder to heal.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.