You will be placed in a kneeling position.
Your skin will be cleaned. An incision will be made in the middle of the back. The overlying
muscles will be moved to the sides. Your surgeon will confirm the correct vertebrae for the
procedure by using x-ray imaging. The ligamentum flavum is separated from the lamina and then
removed. The spinous process and lamina are removed at each level needing to be decompressed.
Next the tracks for the pedicle screws are prepared. The hard bone surface is removed.
A guide track is inserted under X-ray guidance. Its depth and position are checked. Then a
thread is tapped into the bone, and the pedicle screw is placed. The vertebrae are prepared
for the other pedicle screws, and the transverse processes and facet joints are prepared for
the bone graft. Next the bone graft and the remaining pedicle screws are placed. Then
the brackets and rods are installed. X-rays are used to check the position of the screws
and rods. A lateral x-ray will look like this. A posterior x-ray will look like this. The
muscles are replaced, and the wound is closed with sutures.