The ulnar nerves at the elbow are padded to prevent neuropathy. The legs cannot be overflexed. The back is parallel to the ground. A preoperative x-ray with a spinal needle is taken to confirm localization. The back is shaved and prepared.
Unipolar cautery is used to dissect down through midline subcutaneous fat.
The lumbodorsal fascia is opened paramedially. Muscles are stripped from the lamina. A repeat x-ray should confirm the appropriate location. A small laminotomy is created with a drill or rongeurs. The ligament is excised with rongeurs or a knife.