 The iliac veins were carefully mobilized medially, and then the L4-L5 disk space was confirmed by fluoroscopy, and diskectomy fusion, which will be separately dictated by Dr. X, was performed after the adequate exposure was gained, and then after this L4-L5 disk space was fused and the L5-S1 disk space was carefully identified between the iliac vessels and the presacral veins and vessels were ligated with clips, disk was carefully exposed. 
The iliac veins were carefully mobilized medially , and then the L4 - L5 disk space was confirmed by fluoroscopy , and diskectomy fusion , which will be separately dictated by Dr. X , was performed after the adequate exposure was gained , and then after this L4 - L5 disk space was fused and the L5 - S1 disk space was carefully identified between the iliac vessels and the presacral veins and vessels were ligated with clips , disk was carefully exposed .