Facet joint violation during pedicle screw insertion: a cadaveric study of the adult lumbosacral spine comparing the two pedicle screw insertion techniques.

This article analyses the incidence of facet joint violation by pedicle screws inserted via the two most commonly used techniques, intersection and mammillary. Pedicle screws were inserted on each side of fresh-frozen human cadevaric specimen lumbosacral spines using the two techniques. All facet joints which were violated were found to be on the right side, where the mamillary process technique was employed. The incidence of facet joint violation was higher in the mammillary technique, which was statistically significant. The intersection technique appears to be safer than the mamillary with respect to violation of the adjacent superior facet joint.