A
6.4
Insert caudal implants
Lamina Hook (Use for rib-to-lumbar lamina construct)
Make a four centimeter longitudinal paraspinal skin incision
on the concave side of the curve at the lumbar interspace
that was selected preoperatively. Retract the paraspinal mus-
cles laterally. Do not disturb the facet joints.
Use a Lamina Feeler to separate the ligamentum flavum uni-
laterally from the underside of the lamina to ensure good
bony contact with the Lamina Hook and to leave the inter-
spinous ligament intact. Resect enough ligamentum flavum
for the hook to pass.
Choose the appropriate Lamina Hook (right or left). The
hook will be placed downwards and the set screw must be
lateral.
Use the Hook Holding Forceps to place the hook in the de-
sired location on the lumbar vertebra. The hook can be fur-
ther secured by using a heavy, non-absorbable suture around
the posterior spinous process.
Primary Procedure
A Lumbar extension
30
Synthes
VEPTR
Technique Guide
