Objective: To study the determining method for the thoracic and lumbar spinal pedicle screw placement path by stress conduction analysis. Methods: We retrospectively analyzed 520 patients underwent pedicle screw internal fixation between January 2018 and June 2020 in our hospital. Patients were divided into two groups according to the methods of pedicle screw implantation namely, the conventional pedicle screw placement and novel method of pedicle screw implantation determined by spinal stress analysis. Accuracy of spinal pedicle screw placements was evaluated. Intraoperative and postoperative X-ray, CT and intraoperative nerve dissector touch inspection were adopted to determine the success rates of screw placement. Results: Among them 251 patients were treated using conventional screw placement (Group A) and 269 patients were treated using the technique according to analysis of spinal stress (Group B). There were significant differences in terms of the success rate of total of screw placement (92.7% vs.95.8%,P= 0.001) including thoracic screw placement (86.3% vs.94.2%, P = 0.005) and lumbar screw placement (93.8%vs.96.1%,P = 0.016) for Group A and Group B, respectively. Conclusion: Using the novel method of pedicle screw implantation determined by spinal stress might improve the accuracy of pedicle screw implantation. which showed greater reference and application value and the individualized pedicle screw placement was achieved.