Cortical bone screw fixation

Abstract

Placement of lumbar fixation screws using the cortical bone trajectory is a novel and potentially valuable technique. In this chapter, we discuss the current literature on clinical outcomes and biomechanical properties of the cortical bone trajectory. We examine indications for which this trajectory may be beneficial compared to a traditional pedicle screw trajectory. The reader is guided through the steps of performing a minimally invasive midline lumbar fusion using the cortical bone screw trajectory, and an illustrative case is provided. In addition, technical pearls as well as common complications and strategies for their avoidance are discussed.