Posterior decompression and pedicle screw fixation are the most standard techniques used to achieve lumbar arthrodesis, for the treatment of the unstable degenerative lesions.Wide posterior approaches to the lumbarspine, exposing lateral to the facet joints causes an additional degree of muscular damage and blood loss comparing with a simple laminectomy. A new, cortical bone trajectory (CBT) of the pediclescrewhas been proposed as an alternative to the traditional technique. The CBT screw follows a lateral path in the transverse plane and caudo-cephalad path in the sagittal plane. This technique, called Midline Lumbar Interbody Fusion (MIDLIF) it is less invasive, improves screw−bone purchase and reduces neurovascular injury. Between January 2016 and May 2016, ten patients (3 men and 7 women) underwent lumbar interbody fusion using the MIDLF technique instead of traditional pediclescrew fixation for degenerative spondylolisthesis of the lumbar spine. The screws where placed with the assistance of the BrainLab Curve navigation system and the Siemens Artis Zee multi-purpose system. The average patient age was 63,5 years. Prior to surgery, all patients underwent MRI, CT and DEXA scans. The L3 to S1 levels where instrumented. For S1 we used a different trajectory of the screw, oriented to engage with the high-density bone by penetrating the S1 superior endplate. This insertion technique allowed a larger screw to be used, thus increasing the stability of the instrumentation construct. We obtained good postoperative results in all cases. Considerable improvement in both back and leg pain was achieved. In terms of complications, one case of pedicle fracture at the insertion site on the facetectomy side occurred. No dural tear, superior facet violation or screw misplacement where encountered. The mean operation time, radiation exposure and blood loss was significantly less than in the traditional lumbar fusion surgery. We present earlyclinicalresults of a new technique that appeared to have a better fixation profile in laboratory testing. The CBT represents a good alternative option to obtain fixation for the lumbar spine, even in case of low bone quality.