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Spine Surgery: L4-5 and L5-S1 Anterior Lumbar Spinal Fusion Procedure. This medical exhibit displays a bi-level lumbar disc injury with herniation of the L4-5 and L5-S1 intervertebral discs and impingement on the cauda equina of the spinal cord. Surgical steps include the incision into the lower left quadrant of the abdomen, the discectomy (diskectomy) at L5-S1, and the placement of two BAK cages at both levels for final fusion.