<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 49-year-old man comes to the physician because of severe, shooting pain in his lower back for the past 2 weeks. The pain radiates down the back of both legs and started after he lifted a concrete manhole cover from the ground. Physical examination shows decreased sensation to light touch bilaterally over the lateral thigh area and lateral calf bilaterally. Patellar reflex is decreased on both sides. The passive raising of either the right or left leg beyond 30 degrees triggers a shooting pain down the leg past the knee. Which of the following is the most likely underlying cause of this patients current condition?? A: Involuntary contraction of the paraspinal muscles, B: Inflammatory degeneration of the spine, C: Compromised integrity of the vertebral body, D: Herniation of nucleus pulposus into vertebral canal, E: Inflammatory reaction in the epidural space,  <response>: This is a clinical vignette describing a 49-year-old man with severe shooting lower back pain radiating to both legs that started after heavy lifting. The pain is worse with leg raising. On exam he has decreased sensation in the lateral thigh and calf bilaterally as well as decreased patellar reflexes bilaterally. This indicates a nerve root compression causing radicular symptoms. The history of heavy lifting causing the onset of symptoms points towards an acute disc herniation as the most likely cause.D: Herniation of nucleus pulposus into vertebral canal 