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Histomorphometric analysis of bone-screw interface of expansive cervical screw

OBJECTIVE: To perform an experimental study for the Histomorphometric analysis of the bone interface of expansive screws used in the anterior cervical spine fixation system. METHODS: Five sheep cervical vertebrae (C4) were used in the study, in which screws were inserted. The 18.5 mm long and 5.0 mm outer diameter expansive screws (Ulrich) were inserted in both sides of the C4 vertebra. On the left side, the screw was inserted without the internal expansive screw, which was used on the right side. A pilot hole was made on the lower portion of the vertebra with a 2.5 mm bore, but no implant was introduced. The vertebral region containing the screws and the pilot hole was prepared for a histological study of the interface between implants and bone screws, and of the pilot hole wall. Histomorphometric analysis evaluated total bone density, external bone density (outside the screw thread), internal density (inside the screw thread) and the linear measurement of the contact between bone tissue and the implant. RESULTS: Total bone density was greater in group I (expansive screw) as compared to group III (control). External bone density was greater in groups I (expansive screw) and II (non-expansive screw) when compared to group III. Internal bone density was greater in group I when compared to groups II and III, and greater in group II when compared to group III. Linear contact was greater in group I when compared to groups II and III. CONCLUSION: structural changes around expansive screws detected immediately after their application provide subsidies for a better understanding of the greater tearing resistance of the implant, which could be related to the compacting of cancellous bone around the implant, while providing a larger contact area between the implant and the bone tissue.

Spine; Fracture fixation; Bone screws; Cervical vertebrae; Sheep


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