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MIS lumbotomy in L2-L4

Thoracic and lumbar pathologies: Minimally invasive lumbotomy (L2-L4)

Further dissection

The segmental vessels above and below the involved vertebra can be isolated, ligated with sutures and clips, and divided.

Next, the segmental vessels over the involved vertebra can be isolated, ligated, and divided.

For anterior discectomies, these can be spared.

It is mandatory to have a table mounted retraction system to gently retract the psoas muscle, abdominal contents, and great vessels/sympathetic chain.