Review Question - QID 5779

Figure A is the sagittal lumbar spine MRI image of a 59-year-old female complaining of low back pain, which radiates into her bilateral buttocks and posterior thighs. Occasionally she has pain distal to her knee on the left side. Her low back pain is exacerbated when standing up from a sitting position. Prolonged standing and walking seems to worsen the painful radiation to her legs, but says she finds some relief when sitting. Flexion and extension radiographs of the lumbar spine demonstrate 4mm of translation of L4 on L5. She has unsuccessfully completed a six week course of physical therapy. Which of the following treatments is likely to have the greatest effect on bodily pain, physical function, and Oswestry Disability Index (ODI)?