Application of a posture-sensing method combined with blind guidewire probing in percutaneous pedicle screw placement for single-level thoracolumbar compression fractures: a retrospective comparative study.

Abstract

BACKGROUND: Percutaneous pedicle screw fixation is widely used for the minimally invasive treatment of single-level thoracolumbar compression fractures. However, the conventional fluoroscopy-guided technique requires repeated imaging, resulting in increased radiation exposure and prolonged operative time. This study aimed to evaluate the clinical efficacy, safety, and efficiency of a posture-sensing method combined with blind guidewire probing for percutaneous pedicle screw placement. METHODS: This single-center retrospective comparative study included 143 patients with single-level thoracolumbar compression fractures treated between January 2021 and December 2023. Patients were divided into the experimental group (posture-sensing combined with blind guidewire probing, n = 67) and the control group (conventional fluoroscopy-guided technique, n = 76). Perioperative parameters, pedicle screw accuracy based on the Gertzbein–Robbins classification, radiographic outcomes, clinical outcomes (VAS and ODI), and postoperative complications were compared between groups. RESULTS: The experimental group showed significantly shorter operation time (48.6 ± 9.2 vs. 89.4 ± 16.5 min), puncture time (7.1 ± 1.5 vs. 24.3 ± 4.8 min), fewer fluoroscopy exposures (5.6 ± 1.4 vs. 15.2 ± 3.8), and less intraoperative blood loss (51.2 ± 22.8 vs. 93.5 ± 36.2 mL) than the control group (all P < 0.001). The perfect screw placement rate (Grade A) was 85.1% in the experimental group and 84.2% in the control group (P = 0.78), and the clinically acceptable rate (Grade A + B) was 96.3% and 96.1%, respectively (P = 0.93). No significant differences were observed in radiographic restoration, VAS, ODI, or their improvement values between groups (all P > 0.05). Overall complication rates were low and comparable between groups. CONCLUSIONS: The posture-sensing method combined with blind guidewire probing significantly reduces operative time, fluoroscopy exposure, and blood loss while maintaining comparable screw accuracy, radiographic outcomes, and clinical efficacy to the conventional fluoroscopy-guided technique. This method is a safe, efficient, and cost-effective alternative for percutaneous pedicle screw placement, particularly in resource-limited settings.