INTRODUCTION
Though Wiltse developed the paraspinal muscle-splitting approach to the spine, the exact location of where and how to split the paraspinal musculature when performing this approach remains unclear. This type of approach may be particularly useful for posterior nonfusion stabilization as significantly less damage occurs with this approach than with a muscle-stripping approach.

METHODS
We use the term "modified muscle-sparing approach" to describe our technique for following the natural cleavage plane between the multifidus and longissimus muscles to access the spine. We review the rationale behind this methodology and describe technical aspects of this approach and also demonstrate the technique on video.

RESULTS
We use this technique routinely for our posterior nonfusion pedicle screw stabilization approach.

CONCLUSIONS
The modified muscle-sparing approach is a useful approach for insertion of pedicle screw-based posterior nonfusion stabilization. The approach can be readily performed with little blood loss and with little muscle damage. Decompression can also be performed through the same incision if needed.

Key Words MIS, muscle-sparing approach, posterior nonfusion stabilization. SAS Journal. Winter 2008. 2:40–42. DOI: SASJ-2007-0120-MIS

Neel Anand, MD, Eli M. Baron, MD, Robert S. Bray, Jr., MD

From the Institute for Spinal Disorders, Cedars Sinai Medical Center, Los Angeles, California

The authors have no fi nancial interest in relation to the device used in this study.

Address correspondence and reprint requests to Neel Anand, MD, Cedars-Sinai Institute for Spinal Disorders, 444 S. San Vicente Blvd, Ste 800, Los Angeles, California 90048 (email: Neel.Anand@cshs.org)

This manuscript was submitted October 23, 2007, and accepted for publication December 6, 2007.