Objectives: To compare the safety and efficiency of fenestrated cement-augmented pedicle screw with conventional solid cement-augmented pedicle screw technique applied on the patients in the osteoporotic spine with single level lumbar degenerative diseases under the condition of reinserted pedicle screws. Methods 78 cases of single-segment lumbar degenerative disease complicated with osteoporosis during January 2017 to February 2019 were analyzed retrospectively. All cases received the operative method of posterior lumbar interbody fusion with PMMA-strengthening screws paths. The cases were reinserted one pedicle screw during the surgeries due to the difficulties or errors in former insreting procedures. All cases were given regular anti-osteoporosis therapies. The cases were divided into the fenestrated pedicle screw (FPS) group and the conventional solid pedicle screw (CPS) group. 35 cases were in the FPS group while 43 were in the CPS group.The clinical effects were evaluated by VAS and ODI scors of pre-operation and 3-day,3-month,6- month and final follow-up postopertively. Lumbar X-ray and CT scan were taken in the follow-up time mentioned above, in order to estimate the interbody fusion situation and the incidence of the screws loosening. Results: Between two groups, no statistical differences were shown in blood loss during surgeries, rate of surgical complication and the incidence of cement leakage. FPS group showed a lower pedicle screw loosening rate during the follow-up of 3 months,6 months and final follow-up, while significant differences were appeared at 6 months and final follow-up(P＜0.05). In addition, the results of the fusion rate at 3 months, 6 months and 1 year follow-up of the two groups were not statistically sinificant( P＞0.05). Regarding the clinical outcomes, VAS and ODI of both groups were significantly improved (P<0.05). Besides, FPS group achieved significantly better performance in both back pain VAS and ODI at 3 months follow-up (P<0.05). Conclusions: It is effective and safe in treating single level degenerative lumbar diseases with osteoporosis by using fenestrated cement-augmented pedicle screw or solid cement-augmented pedicle screw.Compared to CPS group, the FPS, showed a less screw loosening incidence, lower leakage risk and better fusion rate in the condition of reinserting pedicle screw with a satisfying clinical outcome. Key words: fenestrated pedicle screws; reinserted screw; pedicle screw loosening rate; lumbar degenerative diseases