Conclusion the major cause of malposition of transpedicular screw internal fixation were mutation of and ambiguity of opography induced by spinal congenital malformation , cataplasia , fracture , lumbar olisthe or lateral curvature ; neglect of individuality and poor accuracy in implanting pedicle screw and inadequate understanding of biomechanics of spine about paracentesis 结论脊柱先天畸形、退变、骨折、腰椎滑脱或脊柱侧凸等病变导致椎弓根局部解剖变异或不易辨认，术者未注意个体化、穿刺精度不高以及对经椎弓根穿刺时脊柱生物力学变化理解不够是置钉位置不佳的主要原因。
