Sacralisation of L5, is not a cause for worry at all. It is just normal.
With regard to the other changes and your question about need for surgery, it all depends on what your symptoms are and what difficulties you face from your back.
The MRI report is not too worrying, there is some areas where the disc is worn out but nothing worrying for now.
Next Steps
stay active, maintain healthy weight and exercise regularly. maintain a good posture at all time