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Back Surgery - Anterior L4-5 Interbody Spinal Fusion.  First, the incision over the left side of the torso is cut and then retracted to expose the lower lumbar vertebrae. Next, an L4-5 discectomy is performed and the bone graft is harvested from the iliac crest. Finally, the endplates are removed and a bone graft BAK cage is placed in the L4-5 interspace for the spinal fusion.