— Structure reconstruction of 3D anatomy from biplanar X-ray images is a challenging topic. Traditionally, the elastic-model-based method was used to reconstruct 3D shapes by deforming the control points on the elastic mesh. However, the reconstructed shape is not smooth because the limited control points are only distributed on the edge of the elastic mesh. Alternatively, statistical-model-based methods, which include shape-modelbased and intensity-model-based methods, are introduced due to their smooth reconstruction. However, both suffer from limitations. With the shape-model-based method, only the boundary profile is considered, leading to the loss of valid intensity information. For the intensity-based-method, the computation speed is slow because it needs to calculate the intensity distribution in each iteration. To address these issues, we propose a new reconstruction method using X-ray images and a specimen’s CT data. Specifically, the CT data provides both the shape mesh and the intensity model of the vertebra. Intensity model is used to generate the deformation field from X-ray images, while the shape model is used to generate the patient specific model by applying the calculated deformation field. Experiments on the public synthetic dataset and clinical dataset show that the average reconstruction errors are 1.1 mm and 1.2 mm, separately. The average reconstruction time is 3 minutes.