What does it mean by severe left neural foraminal stenosis at c5-c6 and c6-c7. unchanged area of increased t2 signal within the cervical spinal cord consistent with myelomalacia c4-c5, c5-c6 and c6-c7. yes i had acdf a few yrs ago. will i need surg?

Only if you have intolerable pain which cannot be managed conservatively or if you have arm weakness.

Not feasible here on this educational site to comment on surgical needs. You need to discuss this with your prior surgeon. You might best look at a rehabilitation program to deal with current symptoms, and this can be decided with your doctor. The radiologist could assist your understanding of the films.