Describe a paraspinal approach for removal of a foraminal lumbar disc herniation

The muscles attached to the midline bony structures are left intact. An incision is made in the fascia lateral to the midline. Blunt dissection is carried down to the transverse processes. The transverse processes are identified, and the intertransverse membrane is exposed. A radiograph is obtained to confirm that the correct spinal level has been exposed. The intertransverse membrane is then released, the nerve root is identified and retracted medially, and the disc herniation is removed.

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