In Brief:
A total of 3204 consecutive thoracic pedicle screws were placed by a free hand technique, similar to that used in the lumbar spine. There were no screws (of the entire study group of 3204) with any neurologic, vascular, or visceral complications with up to 10 years of follow-up. This technique performed in a step-wise, consistent and compulsive manner is an accurate, reliable, and safe method of insertion to treat a variety of spinal disorders, including spinal deformity.