The patient’s symptoms and physical examination findings raised serious concern for compression of multiple lumbar and sacral nerve roots in the spine, affecting both motor and sensory pathways. His reduced power in extending his knees and reduced knee reflexes was suggestive of compression of the L4 nerve roots. His reduced ability to dorsiflex his feet and toes was suggestive of compression of the L5 nerve roots. His reduced ankle reflexes was suggestive of compression of the S1 and S2 nerve roots, and his perineal numbness was suggestive of compression of the S3, S4, and S5 nerve roots.