Spinal fusion is the traditional surgical option to improve the clinical outcome of patients with advanced lumbar degenerative disease. Various techniques including posterolateral arthrodesis, interbody arthrodesis, and circumferential arthrodesis are being pursued as fusion strategies to eliminate segmental instability, which is a recognized cause of low back pain [1]. There are several drawbacks associated with pedicle-screw fixation constructs including failure of implant components and back-out of the screws [2,3].

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