The "canoe" technique to insert lumbar pedicle screws: consistent, safe, and simple.

Pedicle screw instrumentation has become standard fixation for a variety of spinal disorders. Traditionally, the landmarks for screw insertion have been described as the junction of the pars interarticularis, with the superior articular process of the corresponding facet and the transverse process. Consistent and reproducible insertion remains challenging specifically when faced with anatomic patient variations and superimposed pathology. We describe a novel method to approach pedicle screw fixation using primarily the transverse process.