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Cortical bone trajectory (CBT) is widely used in orthopedic surgery to improve fixation while minimizing soft tissue dissection. This study used radiological methods to assess the correlation between the bone mineral density (BMD) of vertebrae and Hounsfield unit (HU) values of CBT and traditional trajectory (TT). A total of 240 thoracic and lumbar (T9-L5) vertebrae from 40 cadaveric spines were obtained. The specimens were measured using computed tomography (CT). The axial CT images of TT were sliced in a plane horizontal to the pedicle, whereas those of CBT were sliced in a caudocranial plane. The regions of interest of TT and CBT were selected to calculate an average HU value within the area, wherein the screws were inserted and fixed at 6.0 mm× 40 mm and 4.0 mm× 30 mm, respectively. The BMD of vertebrae was measured by dual-energy X-ray absorptiometry (DEXA) and quantitative CT (QCT). The …