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Midline approach: Skin → subcutaneous fat → supraspinous ligament → interspinous ligament → ligamentum flavum → epidural space → dura mater → arachnoid membrane → subarachnoid space → pia mater → CSF → spinal cord Paramedian approach: Skin → subcutaneous fat → ligamentum flavum → epidural space → dura mater → ...
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