According to the anatomy characteristics of vertebral pedicle and on the basis of puncture site on the skin to the level distance of vertebral process, a three-dimension guider was designed. Eighty-three cases were received percutaneous vertebroplasty from December 2006 to December 2008, including 43 cases with three-dimension guider. Thirty-six cases of above 43 cases puncture site were guided by fluoroscopy, and then performed percutaneous vertebroplasty by three-dimension guider without fluoroscopy monitoring under guidance of preoperative CT measures. The rest 7 cases of 43 were performed percutaneous vertebroplasty by the monitored by fluoroscopy. All cases were successful, and the needle tip could reach the ideal position. Forty cases were received primary two-dimesion guider to perform the percutaneous vertebroplasty, which were monitored by fluoroscopy. The mean puncture time was 1.9 minutes in two-dimension guider while 1.5 minutes in three-dimension guider. Results demonstrated that three-dimension guider has the virtue of logical design, suit for the body anatomy and easy to perform, which can reduce the expose time of x-rays and more safety and efficiency to operators.