A longitudinal skin incision of 20 mm was made on every two spinous processes. The subcutaneous tissue was dissected. The supraspinous ligament was longitudinally separated. The periosteum was dissected to expose the spinous process and the multifidus muscle was preserved. The interspinous ligament was incised. A chisel was used to excise the cranial or caudal tip of the spinous process: 10 mm long, 10 mm wide and 20 mm deep. The ligament was re-sutured, and the skin was closed (Figure 2, Figure 3 and Figure 4).

Operation procedure 1: exposure of spinous process. The skin and the supra-spinous ligament are incised, and the spinous process is exposed. In the actual surgery, a 2 cm skin incision is made, the skin is displaced and two spinous processes are partially excised.

Operation procedure 2: excision of the cranial part of the spinous process. Incise the inter-spinous ligament. A chisel strikes the spinous process.

Operation procedure 3: The cranial portion of the spinous process is removed.

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