The decision to operate is made by the treating physician based on the patient’s condition and needs to be discussed with the patient. The MRI report is a radiologist’s report based on the imaging findings on the film. The radiology report alone cannot be used as a basis for a surgical decision, but only as a reference. The decision to operate depends on the patient’s pain and whether the operation can resolve the patient’s pain. The decision to operate needs to be made based on a combination of the patient’s symptoms and signs, not the radiology report. This is true for basically all diseases, not just herniated lumbar discs, so there is no need to be overly stressed if you see a radiology report stating a herniated lumbar disc.