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INSIGHT Lateral Access System Surgical Technique DePuy Synthes 9
1. Approach the Spine
Locate and mark the correct operative level and asso-
ciated incision site under lateral
fluoroscopy and make a
skin incision. Incision should be large enough to accom-
modate the retractor and subsequent retraction. Retract
the subcutaneous tissue and bluntly dissect through the
abdominal muscle layers and incise the transversalis
fascia to enter the retroperitoneal space (1). Move the
peritoneum anterior with forefinger and continue with
blunt dissection to gently palpate down to the psoas by
following the anterior border of the quadratus lumbo-
rum (2).
Before puncturing the psoas, fluoroscopy is recom
-
mended to ensure targeting the area of interest of
the affected disc space. The anterior third of the psoas
muscle is the most likely safe zone for avoiding the
neural elements of the lumbar plexus.
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Access and Exposure
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Moro et al (2003)
