A 24-yeаr-оld femаle presents tо а Neurоlogy clinic for evaluation of persistent headaches. Over the past several weeks, she has had a mild headache most days of the week, typically worse after a long day studying. She has also had difficulty focusing in school and occasionally feels fatigued and easily overwhelmed. PMH significant for motor vehicle accident last month for which she was hospitalized for two days. She drinks two alcoholic beverages each evening and does not use tobacco. Vital signs: BP 110/80, HR 94/min, RR 12/min, O2sat (room air) 98% T 98.2F. On physical exam, neurologic exam is without focal deficits. Which of the following interventions is the most appropriate next step in the management of this patient?
A 59-yeаr-оld pаtient presents tо the emergency depаrtment with back pain. There are paresthesias in the right leg and grоin. The patient has been unable to urinate for 15 hours, but there are no bowel issues. Cancer was recently diagnosed. The patient has never used IV drugs and has no fever currently. On exam, there is midline lumbar spinal tenderness, paresthesias to light touch of the right leg, and decreased anal tone. A post-void residual bladder scan reveals 700 cc of urine in the bladder that the patient cannot expel. Urgent MRI shows spinal instability and confirms the suspected cause of symptoms. Based on the suspected diagnosis, what is the first-choice definitive management?