Objective To study application value of CT guided percutaneous vertebroplasty (PVP) combined with 3D reconstruction for treatment of thoracolumbar fractures. Methods Clinical data of 526 patients (868 vertebrae) with thoracolumbar fractures treated by CT imaging Pin-point laser navigation system guided PVP from August 2007 to November 2014 in Zhongshan Hospital Affiliated to Zhongshan University, were retrospectively analyzed. According to whether used 3D reconstruction during PVP, patients were divided into two groups, non 3D group (246 cases, 420 vertebrae) and 3D group (280 cases, 448 vertebrae). Visual analogue scale (VAS) scores, central vertebral body height at 1 day preoperatively and 3 days postoperatively were compared between two groups; Forty patients from each group were randomly selected to determine the single vertebral body operation time; Complications such as bone cement leakage, pulmonary embolism, spinal cord compression were observed. Results VAS scores at 3 days after surgery showed similar results in both groups, which were significantly lower than preoperative ones (P <0.05); There were no significant differences in central vertebral body height between preoperation and postoperation; Average single lumbar vertebrae operation time was (22.1 ± 1.1) min in 3D group and (41.1 ± 1.9) min in non 3D group (P <0.05). Four cases had positioning errors and needed to reoperation in non 3D group; Cement leakage had happened in 96 vertebrae in 3D group and 93 in non 3D group, no pulmonary embolism or spinal cord compression aggravation occurred. During 3-6 months (mean 4.5 months) follow-up period, no local pain reoccurred. Conclusion CT guided PVP combined with 3D reconstruction for thoracolumbar fractures could obtain good clinical effect with the advantages of high precision, time-saving and safety.%目的：探讨CT引导结合三维重建技术在胸腰椎骨折经皮椎体成形术（PVP）中的应用价值。方法回顾性分析中山大学附属中山医院2007年8月至2014年11月应用CT成像Pin-point激光导航系统引导下PVP治疗526例（868个椎体）胸腰椎骨折患者的临床资料。根据是否采用CT三维重建技术分为非三维组（246例420个椎体）和三维组（280例448个椎体）。比较两组术前1 d、术后3 d视觉模拟量表（VAS）评分、椎体中心高度；每组随机选择40例患者，记录单个椎体手术时间；观察两组骨水泥渗漏、肺栓塞、脊髓压迫加重等并发症发生情况。结果两组术后3 d VAS评分相当，均明显低于术前（P＜0.05）；两组手术前后椎体中心高度变化不明显（P＞0.05）；三维组与非三维组腰椎单椎体操作时间分别为（22.1±1.1）min和（41.2±1.9）min，两组比较，差异有统计学意义（P＜0.05）；非三维组有4例定位错误需行二次手术，三维组无定位错误；三维组和非三维组分别有96、93个椎体发生骨水泥渗漏，均未发生脊髓压迫加重及肺栓塞。随访3～6个月（平均4.5个月），所有患者疼痛无反复。结论 CT引导下三维重建辅助PVP具有精准性高、省时、安全等优点，临床疗效满意。
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