Fig. 2A–D.

ISO-C CT images of the illustrative case are shown. (A) A two-dimensional fluoroscopy image before screw redirection is shown. (B) Intraoperative isocentric 3-dimensional C-arm axial images demonstrate bilateral T1 pedicle screws that were too lateral. The lateral border of the pedicles is shown. (C) The medial border of the pedicles is shown. (D) The bilateral lateral breakout by the pedicle screws shows 1—the spinous process of the T1 vertebrae; 2—the left pedicle screw; 3—the right pedicle screw. In addition to the lateral breakout, the other indication that the screws are too lateral is the divergent trajectory of the two screws.