Study design: We introduce a simple free hand technique with great ease of application, without angles, measures or degrees, and without any fluoroscopic guidance. It is a safe and reproducible technique. We present our preliminary experience with the use this technique, with inimitable simplicity.
Purpose: The primary aim of the procedure was to achieve adequate screw trajectory in an apparent challenging ease which is reproducible with a good outcome.
Overview of literature: Lateral mass screw fixation is used for posterior subaxial cervical fixation. It was described by Louis and Magerl, then by Anderson, An, and Ebraheim et al. Each one described the procedure with a unique screw entrance point and trajectory.
Technical note: This study is a prospective case study of 45 patients who underwent subaxial cervical lateral mass screw fixation. The screws were inserted using a free hand method. The described free hand technique was found to minimize the morbidity associated with other techniques without compromising the quality of fixation.
Conclusions: Surgical experiences with this technique found it equally safe, rapid, easy, and reproducible.
Keywords: Cervical degenerative disease; free hand technique; instability; lateral mass screw fixation.