EXHIBIT ID: SP_A_1043

Revision Laminectomy L4-5 with Anterior Interbody Fusion

The spinous process is removed. The bilateral laminae are thinned with a drill and removed with rongeurs. Dura is retracted and disc material is removed from inside the disc space. The lateral aspects of L4 and L5 are decorticated. A discectomy is performed through an anterior exposure. A machined allograft implant and anterior fixation plate and screws are placed.