While the patient is under general anesthesia (unconscious and pain-free), an incision is made over the area of the spine that will be treated. The lower spinal vertebrae are often repaired through an incision directly over the spine -- this is called the posterior lumbar approach. The upper spinal vertebrae are often repaired through an incision in the front or side of the neck (anterior cervical spine). The middle spinal vertebrae are sometimes repaired through an incision made in the chest and abdomen (anterior thoracic spine). Depending on the reason for surgery, the procedure may be performed through incisions made on the front, the back, or a combination of both. The vertebrae are fused using bone grafts, with or without pedicle screws, plates, or cages.
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