 At L4-L5, we used a 13-mm PEEK vertebral spacer with structural autograft and BMP, and then we placed a two-level 87-mm Integra sacral plate with 28 x 6-mm screws, two each at L4 and L5 and 36 x 6-mm screws at S1.,OPERATION IN DETAIL:,  The patient was placed under general endotracheal anesthesia. 
At L4 - L5 , we used a 13 - mm PEEK vertebral spacer with structural autograft and BMP , and then we placed a two - level 87 - mm Integra sacral plate with 28 x 6 - mm screws , two each at L4 and L5 and 36 x 6 - mm screws at S1.,OPERATION IN DETAIL : , The patient was placed under general endotracheal anesthesia .