Run from Dura Mater to Flavum and undersurface of lamina. Not widely known and can be confused with peridural adhesions. If unrecognized can lead to dural tears.
Cement at UIV and UIV+1 and DIV and DIV-1 is not just for long constructs but also for medium size construct with osteoporosis ( HU <85)
Classical meningioma in 67 yo woman with gradual difficulty walking and progressive loss of sensation and proprioception.
Hanging gardens: technique of dural repair uses traction sutures on the sides of the repair to keep the running suture line away from neural elements.
Severe rigid curve in an 18 yo with Marfan’s syndrome
Neuromuscular scoliosis: patient with thoracic spina bifida. Severe pelvic obliquity and difficulty sitting.
Extrapedicular fixation: spinolaminar fixation plate
HOMSA ( hybrid open muscle splitting approach) for PJK prevention.
C2-3 Foraminal stenosis causing retroorbital pain and cervicogenic headaches – Not uncommon.
SI fixation on top of S2AI screws to prevent screw loosening and long-term SI pain: part of SYLVIA multicenter randomized trial
