Authors of section

Authors

Han Jo Kim, Marinus de Kleuver, Keith Luk

Executive Editors

Kenneth Cheung, Larry Lenke

General Editor

German Ochoa

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Posterior approach

1. Skin incision

A straight incision is made from the planned UIV to the planned LIV along the midline.

posterior approach

Some surgeons prefer to make a slightly curved incision midway between the apex and the midline. After the correction is completed, the scar will then be located in the midline.

posterior approach

2. Subperiosteal dissection

A subperiosteal dissection is performed bilaterally along the spinous process, the laminae out to the tips of the transverse processes of all the levels.

The use of a subperiosteal dissection can minimize bleeding and muscle damage. The use of self retaining retractors aids in vertebra exposure by holding the musculature off to the side. In addition, packing sponges can help with hemostasis.

Localizing radiograph or image intensifier check of spinal level should be obtained.

posterior approach

The use of self retaining retractors aids in vertebra exposure by holding the musculature off to the side. In addition, packing sponges can help with hemostasis.

Localizing radiograph or image intensifier check of spinal level should be obtained.

The facet joint capsules should also be removed to expose the joints.

posterior approach

3. Closure

Water tight closure of the fascial layer is performed with continuous or interrupted fascial sutures.

posterior approach

A subfascial and/or subcutaneous drain is inserted.

posterior approach

The subcutaneous layers and skin are sutured.

posterior approach
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