I agree. Yes, it's root system has really filled the pot, but as was stated above, the medium looks to be in good condition. Also, since you'd probably mangle the roots a fair amount while extracting the old medium, it might be a bit of a setback right as a new spike is growing.
As to the bigger pot = more root rot comment, that has to do with poor wicking action of media and a lack of air flow to the center of the pot. One way to solve that issue is to invert a mesh pot over the center drainage hole before adding medium - a DIY air-cone pot. I have found that to be a great technique for plants in sphagnum, too.
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