Review Question - QID 214053

A 41-year-old male construction worker presents with 3 weeks of lower back pain and right leg pain that started after lifting a large object. The pain radiates down the back of his thigh, across the lateral aspect of his leg, and into the lateral aspect of his foot. On physical exam, there is decreased sensation in the region that is reportedly painful with 4/5 extensor hallicus longus and 2/5 gastrocsoleus motor strength. The patient has remained off work, has attempted physical therapy, NSAIDs, and methylprednisolone pack. However, physical therapy worsened his right leg pain and he is now experiencing progressive weakness in the affected extremity. He denies any saddle anesthesia, bowel incontinence, or urinary retention. Current images are shown in figures A-D. What is the most appropriate treatment at this time?