Have 3 appointments with docs over the next month - a variety of recommendations from friends across a few medical centers and, I think, representing a variety of approaches (some really anti-surgery, one's a triathlete, one just operated on a colleague). Many thanks to friends for the great research & recos.
Also researching the degeneration bit named in the radiology report as increased "type 1 discogenic endplate marrow degeneration" - a subacute, potentially painful reactive marrow edema at L4-L5 and L5-S1. Fairly difficult to digest articles here - would be handy to understand the use of the word "modic" in this one. Another here.