Review Question - QID 218753

A 71-year-old female presents for a follow-up of severe lower back pain and leg pain due to degenerative scoliosis. She has tried physical therapy, injections, activity modifications, and pain medications without significant improvement. She currently takes apixaban for atrial fibrillation and is on insulin for type 2 diabetes. Her last Hb A1c was 6.3%. She currently smokes 5 cigarettes per day but is cutting back. She is taking oxycodone 10 mg every 12 hours as prescribed by her pain management physician. Her last DEXA scan was significant for a T score of -1.7. What is the best next step for this patient?