Lateral intramuscular planar approach to the lumbar spine and sacrum. Technical note

The goal of this study was to establish a much less invasive method for access to the lateral lumbar spine for posterolateral fusion and pedicle screw (PS) placement. The technique was developed through knowledge of the anatomy literature and the author's clinical experience in more than 90 completed cases. The lateral intramuscular planar approach provides a much less invasive access to the lateral aspect of the lumbar spine and sacrum. An invariant intramuscular plane, poorly described in the anatomical literature, is ideal for posterolateral fusion and/or PS placement from L-3 caudally. The approach requires essentially no resection of the multifidus muscle, or of the pars thoracis of the erector spinae.