"A trans-foraminal modified approach to a Ponte type osteotomy." A trans-foraminal modified approach to a Ponte type osteotomy. We use this trans-foraminal osteotomy (TFO) for larger and less flexible curves. This approach allows for resection of the entire facet joint and ligamentum flavum. In the figure, notice a wide bone resection has been carried out while preserving the midline osteo-ligamentous complex. The tip of the suction is resting on the dura. In idiopathic cases, the ligamentum flavum can be left behind after resection of the facet joint.
Sarwahi et al. Scoliosis 2011 6:16 doi:10.1186/1748-7161-6-16