In Situ Fusion L5 to S1
The patient is taken to the Operating Room and after adequate general anesthesia, is placed prone on a four poster frame (Hall-Relton frame, Jackson table, etc.) with padding under the iliac crest and breast regions. Arms are abducted 20° and elbows flexed 110°. Padding was placed under the down legs and under the down arms. All bony prominences were well padded. The back was given a standard prep and draped free in the usual sterile manner.
A midline incision was made from L4 to S1. The incision was infiltrated with 1/500,000 epinephrine. Dissection was carried down through the subcutaneous tissues, down to the spinous processes of L4–S1.