Mini-Open or Percutaneous Bilateral Lumbar Transfacet Pedicle Screw Fixation A Technical Note

Study Design: Case report. Objective: To describe the technique used to place bilateral lumbar transfacet pedicle screws. Summary of Background Data: Transfacet pedicle screw fixation is a growing alternative and biomechanically comparable with traditional pedicle screw fixation. There is no clear description of technique steps for placing transfacet pedicle screws available in the literature, despite recognizing that screw placement is not intuitive even with fluoroscopy, and is dissimilar to placing traditional pedicle screws or translaminar facet screws. Methods: We present 2 illustrative cases where bilateral transfacet pedicle screws were placed for posterior instrumentation after a step-by-step technique that can be used in a mini-open or percutaenous procedure. Results: Postoperatively, both patients had adequately placed transfacet pedicle screws bilaterally on x-ray imaging with 1 patient demonstrating fusion and intact fixation at 11 months follow-up. Conclusions: Transfacet pedicle screws were successfully placed in 2 patients in a stepwise technique described to achieve lumbar fusion.