SURGICAL TECHNIQUEIntraoperative Radiographic Technique for Visualization of Bicortical or Tricortical Anteromedial Sacral Screw PlacementJain, Nikhil MD; Yu, Elizabeth MDAuthor Information Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH The authors declare no conflict of interest. Reprints: Elizabeth Yu, MD, Department of Orthopaedics, The Ohio State University Wexner Medical Center, 725 Prior Hall, Columbus, OH 43210 (e-mail: firstname.lastname@example.org). Received November 1, 2016 Accepted May 16, 2017 Clinical Spine Surgery: April 2018 - Volume 31 - Issue 3 - p 108-111 doi: 10.1097/BSD.0000000000000561 Buy SDC Metrics Abstract The bicortical anteromedial sacral screw trajectory is the most widely used for S1 screw fixation. The assessment of anterior cortex purchase is difficult on a lateral view due to the overlapping bony anatomy of the sacrum and pelvis. We describe the intraoperative radiographic technique for a personalized pelvic inlet view that is perpendicular to the superior sacral surface to visualize sacral screw placement. This technique allows for assessment of anterior cortex purchase with anteromedial angulation in the same view. © 2018 by Lippincott Williams & Wilkins, Inc.