Posterior instrumentation is often performed to stabilize unstable vertebral segments, often as supplementation to an interbody fusion. The most commonly used posterior instrumentation system in use today is open pedicle screw fixation. The disadvantage to this technique is the major muscle dissection necessary and the related morbidity and scarring. Facet screw fixation offers the advantage of placing a single screw across each articulating joint to immobilize a motion segment, thereby reducing the amount of hardware (and therefore exposure) necessary. Recent studies have shown this type of fixation, for single level stabilization of an anterior (interbody) fusion construct is equally as stable as a pedicle screw construct. Percutaneous facet fixation system uses framed fluoroscopic navigation and small-diameter access channels and instruments to place screws through small incisions, obviating the need for wide muscle exposure. Accurate placement of the facet screws can be determined using radiography and/or neurophysiologic (EMG) screw placement testing. This integrated system maximizes the efficiency of creating a stable fusion construct, while incorporating the advantages of minimal access surgery.