The "medio-latero-superior trajectory technique": an alternative cortical trajectory for pedicle fixation.

An alternative pedicle trajectory for use at the superior end of a construct to limit dissection of the mobile superior facet joint and reduce incision length and muscle dissection, thus minimizing approach-related trauma during pedicle fixation, is reported. The medio-latero-superior trajectory technique involves a starting point on the medial aspect of the pars and angulation of the pedicle screw in a mediolateral and caudocranial direction. This approach takes advantage of a predominantly cortical trajectory to assist with bone fixation. Drawbacks of this new screw trajectory are discussed along with its potential benefits.