Hohenhaus M, Watzlawick R, Masalha W, et al. - This study was carried out to compare top-level screws in percutaneous lumbar instrumentations regarding facet violations and screw pedicle position using navigation or fluoroscopy. Researchers retrospectively separated patients after lumbar percutaneous pedicle screw placement (PPSP) according to the intraoperative technique: navigation or fluoroscopy. In postoperative CT scans, two blinded investigators graded the top-level screws regarding facet violations and pedicle breach. They conducted subsequent matched cohort analysis for comparable groups. The results demonstrate that both intraoperative imaging procedures permit lumbar PPSP with low rates of cranial facet violations whether the surgeon intends to preserve facet integrity. It was noted that navigation was superior concerning accurate pedicle screw position, but could not significantly prevent facet violations.