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.