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

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. 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. 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. 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.