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In an attempt to increase anchoring strength of posterior instrumentation in spine with compromised bone quality, we introduced diagonal trajectory pedicle screwing (hooking screws) that do not rely on screw thread purchase in bone but rather hook onto the strong posterior elements of vertebrae from inside the bone.

Diagonal Trajectory Posterior Screw Instrumentation for Compromised Bone Quality Spine: Groove-Entry Technique/Hooking Screw Hybrid