Protecting cranially located facet joints during pedicle screw placement is one of the modifiable factors that could prevent possible adjacent level problems related with spinal fusion procedure. Placing pedicle screws percutaneously appears to be more challenging in the technical aspect than performing with traditional open technique because of its limited selecting entry point for screw placement. The authors have reported surprisingly higher incidence and risk factors of cranial facet joint violations by percutaneously placed pedicle screws. The purpose of this literature was to illustrate the surgical technique focusing on the tips to avoid cranial facet joint violation during percutaneous placement of pedicle screws.
