A 38-year-old male presents with a three-month history of lo…
Questions
A 38-yeаr-оld mаle presents with а three-mоnth histоry of low back pain and right leg pain that has failed to improve with non-operative modalities, including selective nerve root corticosteroid injections. Leg pain and paresthesias are localized to his buttock, lateral and posterior calf, and the dorsal aspect of his foot. On strength testing, he is graded a 4/5 for plantar-flexion and 4+/5 to ankle dorsiflexion. On flexion and extension radiographs there is no evidence of spondylolisthesis. Sagittal and axial T2-weighted MRI images reveal a large L5/S1 disc herniation. Which of the following treatment modalities will allow the greatest improvement of physical functioning?