ABSTRACT
Transpedicular fixation is currently the most widely used method of supplementation of an Anterior lumbar interbody fusion construct. Standard pedicle screw insertion techniques can increase the operative time, blood loss, reoperation rates, and the rate of complications. The concept of spinal arthrodesis is based on experience with other regions of the body in which arthrodesis has been used to treat painful joints by elimination of motion. Initially, spinal fusion was used to treat instability due to infectious conditions, tumors, trauma. The minimally invasive technique with open midline exposure of the posterior spine allows the surgeon to visualize the translaminar passage of the screws under direct vision and enable a posterior spinal fusion, if desired, for a true circumferential arthrodesis. The advantages of using translaminar facet screws are that a relatively small incision is used with minimal muscle dissection. The patency of the inner lamina wall can be palpated similar to the palpation of a pilot hole for pedicle screw insertion.
