Neupsy Key

•  The initial exposure should involve subperiosteal dissection of the muscle to the facet joint. •  Resection of the facet capsule and exposure of the superior articular process (caudad vertebra)…

•  Typical lateral positioning of the patient. •  The dilator has been docked over the pathologic vertebral body. The psoas is retracted posteriorly. •  A high speed burr is used…

•  Rib exposure. The anterior and posterior margins of the vertebral body to be resected are marked using fluoroscopy. The overlying rib is subperiosteally exposed. •  The inferior portion of…

•  Biplanar fluoroscopy is used throughout the procedure. •  The starting position for the cannula should be at the 10 o’clock or 2 o’clock position of the pedicle (superior-lateral corner…

•  Exposure of the hemilamina. •  The high-speed burr is used to remove the lamina. •  Detachment of the ligamentum flavum from the superior L4 lamina. •  Undercutting the ipsalateral…

•  A midline posterior cervical exposure is performed. •  Care is taken not to strip the facet capsule. •  Only the medial portion of the lamina/facet junction is exposed. • …

•  Meticulous dissection should be performed with the inferior 3–5 mm of the inferior facet osteotomized. The base of the superior articular process is a key landmark for entry into…

•  Before the corpectomy is begun, the disk space above and below the vertebral body to be resected is clearly exposed. •  The uncovertebral margin is the most reliable reference…

Anterior Lumbar •  The patient is positioned with his or her arms across the chest. This allows for the c-arm to be moved cephalad in the field. A lateral c…

•  A midline posterior approach is utilized, with dissection performed through the avascular ligamentum nuchae. •  Subperiosteal exposure is performed, extending out to the lateral edge of the lateral mass….