{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:59:11Z","timestamp":1792792751793,"version":"4.5.0"},"reference-count":60,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>The traditional posterior median approach laminectomy is widely used for lumbar decompression. However, the bilateral dissection of paraspinal muscles during this procedure often leads to postoperative muscle atrophy, chronic low back pain, and other complications. The posterior midline spinous process\u2010splitting approach (SPSA) offers a significant advantage over the traditional approach by minimizing damage to the paraspinal muscles. SPSA reduces the incidence of muscle atrophy and chronic low back pain while maintaining the integrity of the posterior spinal structures. The technique involves longitudinal splitting of the spinous process, which allows for adequate access to the lamina for decompression without detaching the paraspinal muscles. As a result, it provides a clearer surgical field and facilitates muscle preservation, which reduces the risk of postoperative complications. Additionally, SPSA requires only standard surgical instruments, making it accessible in most surgical settings. This paper reviews the anatomical considerations, surgical techniques, and clinical applications of the SPSA, highlighting its effectiveness in reducing muscle atrophy and improving recovery outcomes. The paper also discusses its potential in treating conditions such as lumbar spinal stenosis, disc herniation, and spondylolisthesis. Furthermore, it emphasizes the need for future research to establish the long\u2010term benefits of SPSA and refine surgical techniques. The results suggest that SPSA is a promising alternative to traditional approaches, with better outcomes in terms of muscle preservation and overall recovery.<\/jats:p>","DOI":"10.1111\/os.14355","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T07:09:57Z","timestamp":1736320197000},"page":"990-998","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Research Progress on the Posterior Midline Lumbar Spinous Process\u2010Splitting Approach"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6615-2445","authenticated-orcid":false,"given":"Yizhong","family":"Ma","sequence":"first","affiliation":[{"name":"Health Science Center Ningbo University  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4868-6091","authenticated-orcid":false,"given":"Lu","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Zhongda Hospital, School of Medicine Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3023-5332","authenticated-orcid":false,"given":"Guanyi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Ningbo No. 6 Hospital  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery The Quzhou Affiliated Hospital of Wenzhou Medical University  Quzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaixuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Health Science Center Ningbo University  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,7]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000198726.62514.75"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000248132.15231.fe"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp0708097"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2009.03.005"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199201000-00001"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199911010-00010"},{"key":"e_1_2_14_8_1","first-page":"80","article-title":"Electromyography in Paraspinal Muscles Following Surgery for Root Compression","volume":"56","author":"See D. 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