Osteophytes and Hypertophy of Ligaments casuing - stenosis PLEASE HELP

Thanks a lot for your previos answer.

I have pain and tingling (in the feet) in the left leg when I walk or stand. Here is the MRI impression
L4/5 diffuse disc bulge, end plate osteophyte seen causing moderate left greater than rignt Nueral foraminal stenosis and moderate central stenosis. Also there is some hypertophy of ligaments seen at this level
At all other levels everything is normal.
The MRI said the osteophyte are impressing upon the thecal sac but did not clearly comment on any nerve getting pinched.

1. I have 3 things at L4/5
   Diffuse bulge : which goes away with time
   Hypertrophy of ligaments : what can I do to treat this
   Osteophyte : Which does not go away, but what can be done  
   to treat them.
2. How fast do these osteophytes grow(months/years). Is there
   any other treatment for them other than removing them by
   surgery
3. I have heard of a laser proceedure "Formenoplasty" to clear
   the foramens blocked by osteophytes/disc. Do you have any  
   suggestion on this proceedure.
4. How long can I wait for surgery (if at all required). Is
   there any harm in delaying it for a 2-3 years even if the
   symptoms get bad.We are planning to start a family and dont
   want us to be too stressed about this issue.
5. If the nerve is getting pinched what can I do so that it does
   not become worse. I commute about 1.5 hours each way to go to
   work and sit there for 8-9 hours is it not advisable
6. Should I be too worried about the thecal sac getting
   impressed now

Please advice, Thanks

[CCF-Neuro-M.D.-JT]

I can understand your concern about the symptoms. However, it would be unfair to you if I tried to answer all of your detailed questions without actually examining you or reviewing your films.What I can tell you is that osteophytes are not like bacteria or cancer that grow rapidly. They represent the normal aging process of wear and tear and take years of degeneration, though in your case it's just now starting to be symptomatic by compressing your nerve. You really need to see a neurologist and get a formal exam. If there are objective signs of damage such as a foot drop or severe sensory disturbances, then surgery should be considered at about the 6 week mark after onset of symptoms. How long you should wait depends on what a doctor finds on your exam and the actual state of your films (we always rely on our own personal review rather than a radiologist). FOr now, take it easy, try some NSAIDS, maybe some physical therapy and get an appointment with a neurologist.