SEX : Male Age 68 This is a Commercial Payer ( Follow Medicare rules . External causes are NOT required ) PREOPERATIVE DIAGNOSIS : Previous spinal fusion at the L5 - S1 level with stenosis at L4 - L5 with claudication . POSTOPERATIVE DIAGNOSIS : Previous spinal fusion at the L5 - S1 level with stenosis at L4 - L5 with claudication NAME OF PROCEDURE : Repeat spinal surgery . Lumbar laminotomy L4-5 with foraminotomy .