Post-test: Anatomy of a Lumbar Spine MRI: Indications for Imaging and Interpretation of Imaging for Surgical Referral

An otherwise healthy 55-year-old man currently employed as a mechanic presents with 5-year history of progressive back pain impeding his ability to continue working. He denies any constitutional symptoms or pain in his legs. He has intermittent numbness in his left buttock radiating to his left foot. Radiographs of the lumbar spine demonstrate only moderate degenerative changes. The patient has participated in 6 weeks of conservative management consisting of acupuncture and massage therapy. What is the most appropriate next step in his management?