Review Question - QID 219708

A 68-year-old woman with an intellectual disability presents to the spine clinic for evaluation of shooting pain into her right leg for several years. She has difficulty describing the pain in her leg. She denies axial back pain at this time. She has a history of remote lumbar decompression and fusion but cannot remember when or what symptoms preceded her initial surgery. Radiographs and selected MRI sequences are presented in Figures A, B, and C. Subsequent CT is presented in Figure D. On examination, she has weakness to hallux extension and ankle plantarflexion, as well as diminished sensation in her anterolateral leg and foot. Which of the following is the next best step in treatment?