OrthoNet

Cervical spine - posterior approach

* position - prone

* incision - midline of neck

* internervous plane - midline btw L & R paracervical muscles (post. rami of cervical n.)

* dissection
- continue incision down to spinous processes
- expose post. aspect of vert. subperiosteally
- identify lig. flavum running btw adj. lamina
- remove from leading edge of lamina of inf. vert.
- remove remaining lig. flavum & lamina
- retract SC med.
- identify post. portionof vert. body

* dangers
- SC & nerve roots - don’t retract too vigorously
- venous plexus in canal - use gelfoam or bipolar cautery
- segmental blood supply
> may be cut or stretched as muscles stripped past facet joints
> usu causes no problems
- vert. art. - protected by bone b/c within transverse foramen