• Zhemin Zhu, Shengxuan Hu, Weibo Zeng, Shuizhong Cen, Yubin Liu, Wei Zhang, and Benchao Shi.
• Department of Spinal Surgery, Zhujiang Hospital of Southern Medical University, 253# industry road, Guangzhou, 510280, Guangdong, China.
• Eur Spine J. 2024 Jan 1; 33 (1): 298306298-306.

PurposeThe objective of this study was to investigate the optimal entry point and pedicle camber angle for L5 pedicle screws of different canal types.MethodsCT imaging data were processed by Mimics for simulated pedicle screw placement, and PD (Pedicle diameter), PCA (Pedicle camber angle), LD (Longitudinal distance), TD (Transverse distance), and PBG (Pedicle screw breach grade) were measured. Then they were divided into the Round group and Trefoil group according to the type of spinal canal. When comparing PD, PCA, LD, TD, and PBG, the two sides of the pedicle were compared separately, so they were first divided into the round-type pedicle group and the trefoil-type pedicle group.ResultsIn the round-type pedicle group (n = 134) and the trefoil-type pedicle group (n = 264), there was no significant difference in PD and LD, but there was a significant difference in PCA between the two groups (t = - 4.072, P < 0.05). A statistically significant difference in the distance of the Magerl point relative to the optimal entry point (t = - 3.792, P < 0.05), and the distance of the Magerl point relative to the optimal entry point was greater in the trefoil-type pedicle group than in the round-type pedicle group.ConclusionThe optimal entry point for L5 is more outward than the Magerl point, and the Trefoil spinal canal L5 is more outwardly oriented than the Round spinal canal L5, with a greater angle of abduction during pedicle screw placement.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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