•  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 the pedicle. The starting point for each thoracic screw varies. Biomechanically, it is best to place the screws parallel to the superior end plate. When the procedure is started distal at T12, there is a trend toward a more medial and cephalad pedicle starting point as one proceeds toward the midthoracic region (T7–T8). Proximal to this point, the starting point moves more lateral and caudad as one proceeds to the upper thoracic spine.

•  A burr may be used to create a pedicle blush by removing only the dorsal cortex in the area of the targeted pedicle entry point.

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Cervical Surgical Positioning Posterior Cervical Laminectomy and Fusion Posterior Cervical Laminaplasty with Instrumentation Minimally Invasive Thoracic Corpectomy Open Laminectomy and Diskectomy Percutaneous Pedicle Screw Placement

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