Jill underwent several previous failed surgeries, including a broken screw, pseudoarthrosis, and lack of bone healing at L4-5 level. Dr. Melamed performed an anterior lumbar interbody fusion by going in the front, removing the cage, and fusing the L4-5 level. This was followed by posterior instrumentation and pedicle screws to reinforce the fusion, and posterior fusion, at the same time. This gave Jill maximum stability and much accelerated healing!