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FIGURE 44.188
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A, Posterior peritoneum opened and middle sacral artery ligated. B, Anterior longitudinal ligament opened, and small piece of bone removed from lower lip of L5. C, After discectomy, structural autogenous grafts placed. D, Anterior longitudinal ligament reattached through osseous channels and posterior peritoneal and laparotomy incisions are subsequently closed. SEE TECHNIQUE 44.58.

出典

img 1:  From Helenius I, Remes V, Poussa M: Uninstrumented in situ fusion for high-grade childhood and adolescent isthmic spondylolisthesis: long-term outcome, J Bone Joint Surg 90A:145, 2008.