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目的：比较电钻驱动法和徒手克氏针加叩击法在腰椎椎弓根( lumbar pedicle screw，LPS )螺钉置入中的精确性和安全性。方法回顾性分析2008年1月至2011年12月，于我院行后路椎弓根螺钉内固定矫形技术治疗的腰椎结构性脊柱侧凸患者157例，其中男48例，女109例；年龄9～19岁，平均(14.6±5.8)岁。其中采用克氏针加叩击法技术置钉85例(徒手组)，电钻驱动法置钉72例(电钻组)。两组患者术后均行 CT 扫描，记录螺钉穿透骨皮质的数目、位置和距离，以比较两组置钉精确性及凸侧与凹侧置钉精确性的差异。结果两组共置入 LPS 螺钉1118枚，总皮质穿破率为9.3%。徒手组共置入642枚螺钉，其中64枚穿破皮质(穿破率10.0%)；电钻组共置入476枚螺钉，其中40枚发生皮质穿破(穿破率8.4%)。两组皮质穿破率比较差异无统计学意义( P＞0.05)。电钻组凸侧穿破率9.7%(23/236)，凹侧7.1%(17/240)，徒手组凸侧穿破率8.8%(28/317)，凹侧11.1%(36/325)，两种方法凸、凹侧比较差异无统计学意义( P＞0.05)。所有患者术中和术后均无神经、血管或内脏损伤等并发症。结论在脊柱侧凸矫形手术中，应用电钻驱动辅助行 LPS螺钉置入与传统徒手克氏针加叩击法相比，同样有较高的精确性和安全性。“,”Objective To evaluate the accuracy and safety of the “electric drill -assisted” technique in placing lumbar pedicle screw ( LPS ), comparing with the conventional “freehand” technique. Methods A total of 157 patients ( 48 males and 109 females ) with lumbar scoliosis were included in the study from January 2008 to December 2011. The average age was ( 14.6 ± 5.8 ) years ( range: 9 - 19 years ). The patients were divided into Kirschner wire ( free hand ) group ( n = 85 ) and electric drill-assisted group ( n = 72 ) according to different methods of canal preparation. Post-operative computed tomography ( CT ) was acquired to determine the distribution of the cortical perforation and the distance between the screw tip and cortical perforation. χ2 test was performed to compare the differences of 2 groups on the convex side and concave side. Results All 1118 lumbar pedicle screws were inserted in 157 patients with scoliosis. The incidence of cortical perforation was 9.3%. Sixty-four of 642 screws ( 10.0% ) perforated cortices in the free hand group, 40 of 476 screws ( 8.4% ) perforated cortices in the electric drill-assisted group. No significant differences of the perforation rate were found between the 2 groups ( P > 0.05 ). In the electric drill-assisted group, the incidence of cortical perforation was 9.7% ( 23 / 236 ) on the convex side and 7.1% ( 17 / 240 ) on the concave side. In the free hand group, the incidence of cortical perforation was 8.8% ( 28 / 317 ) on the convex side and 11.1%( 36 / 325 ) on the concave side. There were no statistical differences between the 2 groups ( P > 0.05 ). No neurological, vascular, or visceral complications caused by LPS placement occurred in both groups. Conclusions The electric drill-assisted technique shows similar accuracy and safety in placing LPS, comparing with the conventional Kirschner wire technique.