OBJECTIVE To evaluate the accuracy of a novel guidance method of pedicle screw implantation determined by spinal stress. METHODS We retrospectively analyzed patients underwent pedicle screw internal fixation between January 2015 and August 2018 in our hospital. Patients were divided into two groups according to the methods of pedicle screw implantation namely, the conventional nail placement and novel guidance method of pedicle screw implantation determined by spinal stress. Accuracy of spinal pedicle screw placements was evaluated using intraoperative and postoperative X-ray computed tomography (CT) examination and intraoperative touch of nerve root dissection pedicle bone. The success rate of intraoperative one-time screw placement was calculated according to Heary classification I. RESULTS A total of 785 patients underwent pedicle screw internal fixation were retrospectively analyzed. Among them 384 patients were treated using conventional nail placement (Group A) and 401 patients were treated using the technique according to analysis of spinal stress (Group B). There was no significant difference in terms of the characteristics between two groups. There were significant differences in terms of the success rate of total of screw placement (88.7% vs. 96.2%, P < 0.001) including thoracic screw placement (87.8% vs. 94.5%, P = 0.003) and lumbar screw placement (88.8% vs. 96.5%, P = 0.001) for Group A and Group B, respectively. CONCLUSIONS Using the novel guidance method of pedicle screw implantation determined by spinal stress might improve the accuracy of pedicle screw implantation.

中文翻译：

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脊柱应力分析在X射线引导下确定椎弓根螺钉放置方法中的应用。

目的评估一种由脊柱应力确定的新型椎弓根螺钉植入引导方法的准确性。方法回顾性分析2015年1月至2018年8月在我院接受椎弓根螺钉内固定的患者。根据椎弓根螺钉植入方法将患者分为两组，即常规的钉子放置和由脊柱应力确定的新型椎弓根螺钉植入引导方法。使用术中和术后X射线计算机断层扫描（CT）检查以及术中触及神经根解剖蒂椎弓根骨来评估椎弓根螺钉放置的准确性。根据Heary分类I计算术中一次置入螺钉的成功率。结果对785例行椎弓根螺钉内固定的患者进行回顾性分析。其中384例采用常规指甲放置治疗（A组），401例采用根据脊柱应力分析的技术治疗（B组）。两组之间在特征方面没有显着差异。包括置入胸椎螺钉（87.8％vs. 94.5％，P = 0.003）和置入腰椎螺钉（88.8％）的总螺钉置入成功率（88.7％vs. 96.2％，P <0.001）存在显着差异。分别为A组和B组的96.5％，P = 0.001）。结论采用由脊柱应力确定的新型椎弓根螺钉植入引导方法可以提高椎弓根螺钉植入的准确性。