Is your orthopedist a spine surgeon who specializes in spines only?

If not you should seek out the opinion of a spine specialist, either an orthopedic surgeon who specializes in spines or a neurosurgeon who specializes in spines only.

If your orthopedist is a spine specialist and you are not satisfied with his recommendation, then you should seek out another opinion.

ESI is a common approach for what your MRI says, along with a course of Physical therapy to strengthen your core muscles.

There may be no nerve compression in the foramen itself, but you could have nerve compression in the lateral recess area of the vertebrae.
That is something that is commonly missed or ignored by many spine surgeons.

Fran