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Objective: To evaluate the accuracy of computer-assisted pedicle screw installation and its clinical benefit as compared with conventional pedicle screw installation techniques. Methods: Total 176 thoracic pedicle screws placed in 42 thoracic fracture patients were involved in the study randomly, 20 patients under conventional fluoroscopic control (84 screws) and 22 patients had screw insertion under three dimensional (3D) computer-assisted navigation (92 screws). The 2 groups were compared for accuracy of screw placement, time for screw insertion by postoperative thincut CT scans and statistical analysis by x2 test. The cortical perforations were then graded by 2-mm increments: Grade Ⅰ (good, no cortical perforation), Grade Ⅱ (screw outside the pedicle 2 mm).Results: In computer assisted group, 88 (95.65%) were Grade Ⅰ (good), 4 (4.35%) were Grade Ⅱ (2 mm) violations. In conventional group, there were 14 cortical violations (16.67%), 70 (83.33%) were Grade Ⅰ (good),11 (13.1%) were Grade Ⅱ (2 mm) violations (P