A biomechanical study. To evaluate the efficacy and feasibility of cement-augmented cortical bone trajectory (CBT) screw fixation. Forty-nine CBT screws were inserted into lumbar vertebrae guided by three-dimensionally printed templates, and then injected with 0, .5, or 1.0mL of polymethylmethacrylate. The screw placement accuracy, cement dispersion, and cement leakage rate were evaluated radiologically. Biomechanical tests were performed to measure the axial pull-out strength and torque value. Overall, 83.67% of the screws were inserted without pedicle perforation. In the 1.0mL group, cement dispersed into the pedicle zone and formed a concentrated mass more often than in the .5mL group, but not significantly more often (P > .05). The total cement leakage rate was 18.75%. Compared with the control group, the torque value was slightly higher in the .5mL group (P = .735) and significantly higher in the 1.0mL group (P = .026). However, there was no significant difference between the .5 and 1.0mL groups (P = .431). The maximal pull-out force (Fmax) was increased by 52.85% and 72.73% in the .5 and 1.0mL groups, respectively, compared with the control group (P < .05). However, the difference was not significant between the 2 cemented groups (P = .985). Cement augmentation is a useful method for increasing CBT screw stability in osteoporotic spines. The cement injection volume is recommended to be 1mL for each screw, and the cement should disperse into the vertebral body than the pedicle zones.