• Faiz Ahmad, Jonathan D Sherman, and Michael Y Wang.
• Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
• World Neurosurg. 2012 Dec 1;78(6):716.e1-4.

BackgroundNumerous innovative minimally invasive fusion and fixation techniques for the thoracolumbar spine have recently been developed. However, less-invasive approaches for accessing the posterior cervical spine surgery have been more elusive. One promising option for posterior cervical fixation is trans-facet screw placement.Surgical TechniqueThis method allows for a screw to be inserted percutaneously through the articular (zygapophyseal) facet joint. This eliminates the need for a connecting rod between segments, which remains a major limitation of longer segment minimally invasive lateral mass screw-rod constructs. Surgery was successfully performed in three consecutive cases with the use of existing small fragment cancellous screws intended for orthopedic applications.ConclusionsIn this report we describe an initial clinical experience with cervical trans-facet screws, which we found to be a technically feasible option in the subaxial cervical spine for truly percutaneous spinal fixation. However, until percutaneous bony fusion methods are developed, this approach is limited to the fixation application, such as supplementing an anterior fusion construct.Copyright © 2012 Elsevier Inc. All rights reserved.

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