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Biomechanical studies demonstrate that cortical bone trajectory pedicle screws (CBTPS) have greater pullout strength than traditional pedicle screws with a lateral-medial trajectory. CBTPS start on the pars and angulate in a mediolateral-caudocranial direction. To our knowledge, no large series exists evaluating the perioperative outcomes and safety of CBTPS.

We retrospectively reviewed all patients who received lumbar CBTPS at our institution. Data were collected regarding patient demographics, use of image guidance, operative blood loss, hospital stay, and postoperative complications.

A total of 79 patients undergoing CBTPS fusion for degenerative lumbosacral disease with back pain were included in the analysis (42 female, 37 male; October 2011–January 2015). Twenty patients (25.3%) had previous lumbar spine surgery, 39 (49.4%) had a smoking history, and mean body mass …