Dorsal midline approach to the thoracolumbar spine

With the patient in sternal recumbency.

A dorsal midline skin incision is performed over the dorsal spinous processes centered over the injured vertebrae.

Radiographic markers like staples are used to define the precise location of the skin incision.

The incision extends through the skin, the subcutis, and the supraspinous ligament.

The dorsal ligaments are bluntly separated to gain access to the bone.