The use of a pedicle screw-cortical screw hybrid system for the surgical treatment of a patient with congenital multilevel spinal non-segmentation defect and spinal column deformity: a technical note.

INTRODUCTION: This technical note presents, to the authors' knowledge, the first reported case of a hybrid pedicle-cortical screw system for instrumented fusion in a patient with congenital vertebral column deformity. CASE: Cortical screws were navigated using stereotactic guidance to extend a prior non-segmented fusion mass, facilitating instrumentation in a circumstance with completely distorted anatomy. This technique provided a safe trajectory with excellent cortical purchase in an anatomically deformed spine. DISCUSSION: Cortical screw fixation may serve to be helpful in augmenting pedicle screw fixation and in circumstances in which the bone quality is suboptimal or the pedicles are compromised. Cortical screw fixation is a relatively new technology, but it may prove to be invaluable in providing an adjunct to pedicle screw constructs in anatomically distorted or osteoporotic spines.