VALLEY COTTAGE, N.Y. – Over the last two decades, there has been a significant progress in the pedicle screw instrumentation technique for the spine. The use of pedicle screws has gradually progressed from the use in the lumbar spine to their use in more complex anatomy such as the thoracic and thoracolumbar level. The pedicular screws have several advantages over the conventional rod and hook constructs. The pedicular screw allows spinal arthrodesis stability and offers three column control over the spinal elements thereby improving deformation. The placement of the pedicle screw is independent of the laminar integrity thereby expanding its application to a different level of spinal pathologies such as degenerative, oncologic, degenerative and deformity correction.