The invention discloses a three-dimensional adjustable combined guiding system for assisting in implanting screws into the vertebral pedicle, and belongs to the field of medical instruments. The purpose is to solve the problem that when the screws are implanted in a spine surgery operation, accurate guiding can not be achieved if only depending on experience estimation and manual operation. The guiding system comprises a sliding rail, spinous process fixing clamps, a drilling angle adjustor, retractable abduction frames and vertebral pedicle screw guiding tubes. A designing conception and a using method are characterized in that a, before an operation, the optimal needle inserting angle is accurately measured according to imageological examination; b, according to the result, the drilling angle adjustor is adjusted to lock the angle so that the unique accurate screw implanting angle of three-dimensional space can be determined; c, the drilling angle adjustor moves along the sliding rail, and the length of the retractable abduction frame is adjusted and locked to control the distance between a screw-entering point and the central axis of the spinous process so that the guiding tubes can be tightly attached to the needle-entering point; d, screw implanting operation is performed inside the guiding tubes. The guiding system can be adjusted and combined. Experience estimation of implanting the screws into the vertebral pedicle is changed into quantified measurement, screw implanting safety and accuracy are high, and operability is high.