title: Anatomic features of the paramedian muscle-splitting approaches to the lumbar spine.
abstract: BACKGROUND
  Intermuscular approaches can expose the lumbar spine and minimize muscular trauma and injury. The segmental anatomy of the posterior lumbar musculature allows surgical access through separation of muscle groups and fascicles and provides one to develop intermuscular working channels while preserving the integrity of the muscles and their function. In addition, preservation of the accompanying neurovascular bundles minimizes blood loss, tissue atrophy, and pain. With these approaches, a variety of procedures for decompression, discectomy, interbody fusion, or pedicle screw fixation can be achieved for single or multiple levels without subperiosteal stripping or muscle transection.
  
  
  OBJECTIVE
  A detailed description of the relevant surgical anatomy for the muscle-sparing approach to the lumbar spine.
authors.affiliation: Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA. dhoh@usc.edu
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Hoh
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Wang
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Ritland
mesh_terms: D019299:Decompression, Surgical / Q000379:methods; D017586:Diskectomy / Q000379:methods; D004210:Dissection / Q000379:methods; D006801:Humans; D008159:Lumbar Vertebrae / Q000033:anatomy & histology* / Q000601:surgery*; D018482:Muscle, Skeletal / Q000098:blood supply / Q000294:innervation* / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D013122:Spinal Diseases / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D013710:Tendons / Q000033:anatomy & histology / Q000601:surgery; D021801:Zygapophyseal Joint / Q000098:blood supply / Q000294:innervation / Q000601:surgery