Once the surgical fixation and decompression have been performed, the muscles are approximated over a deep suction drain using interrupted sutures.
The fascial layer is then closed with continuous or interrupted sutures.
At the time of writing this text, there are several articles showing that the use of vancomycin powder prior to closure may decrease infection rate.
The approximation of the posterior cervicothoracic muscles is subject to considerable tension and fascial dehiscence. The use of nonabsorbable sutures for fascial closure should be considered.