Tears in the dura occur more often in cases where ligamentum flavum adheres to lamina. At a recent spine surgery workshop, Dr. Howard An suggested using angled periosteal elevators as an effective means of stripping the ligamentum away from the lamina prior to introduction of a Kerrison punch.

It just so happens that Buxton's Bruett series of double-ended elevator/raspatories are ideally suited for separating clinging dura from its neighbors. The 72-3742 is sharp/sharp with one straight blade and the other bent 90º, while the 72-3744 features two right angle blades in sharp and blunt. The blunted right angle blades of the 72-3746 sit on 30° angled shafts and stare inquisitively into the wound site.

Talking Back, Vol. 2, No. 2.