[Objective]: To investigate the clinical efficacy of cortical bone trajectory and pedicle screw in the treatment of lumbar degenerative and osteoporosis patients.[Methods]: A total of 87 patients underwent pedicle screw and cortical bone trajectory from May 2016 to May 2018 in Binzhou medical university hospital . A total of 65 patients were enrolled （35 patients with pedicle screw and 30 patients with cortical bone trajectory）according to the inclusion and exclusion criteria. The data was collected and recorded including the preoperative and postoperative VAS, JOA, the amount of blood loss, the operation time, and the postoperative screw loosening and fusion. The follow-up time was more than 9 months, with an average of 9.3 months. The data was analyzed by SPSS.19 for statistical analysis of the clinical efficacy of the two surgical methods. [Results]: In the relief of pain and improvement of dysfunction in patients, the two groups of patients improved significantly after surgery(p<0.05), the effect was similar between the two groups (p>0.05); The amount of blood loss, operation time , the cortical bone trajectory group was significantly better than the pedicle screw group (p<0.05), but the effect was similar in short-term fusion and screw loosening（p>0.05）. [Conclusion]: Cortical bone trajectory and pedicle screw have achieved good results in the treatment of lumbar degenerative and osteoporosis patients.Cortical bone trajectory is superior to pedicle screw in terms of blood loss, operation time.