Skip to main content
Top
Published in: European Spine Journal 5/2012

01-05-2012 | Original Article

Experimental in vivo acute and chronic biomechanical and histomorphometrical comparison of self-drilling and self-tapping anterior cervical screws

Authors: Maximiliano Aguiar Porto, Patrícia Silva, Rodrigo Rosa, José Batista Volpon, Antônio Carlos Shimano, Francisco José Albuquerque de Paula, Helton Luiz Aparecido Defino

Published in: European Spine Journal | Issue 5/2012

Login to get access

Abstract

Purpose

Self-drilling screws (SDS) and self-tapping screws (STS) allow for quicker bone insertion and are associated with increased anchorage. This is an experimental in vivo comparison of anterior cervical SDS and STS in the post-insertion acute and chronic phases.

Methods

Thirty C2–C6 vertebrae from six Santa Inês hair sheep were used. Each screw design was randomly assigned to five of each spinal level. Insertion torque was measured using a torque device. Three animals were killed in each phase. Vertebrae were randomly assigned to pullout tests and histomorphometrical bone–screw interface evaluation (percent screw–bone contact and bone density inside and outside the threaded area). Statistical significance was set at P < 0.05.

Results

SDS insertion torque was greater than STS (P = 0.0001). SDS pullout strength was significantly greater than STS in the acute and chronic phases (P = 0.0001, 0.0003, respectively). SDS percent screw–bone contact and inside area bone density were significantly greater in both phases. No outside area bone density differences were observed in either phase.

Conclusions

SDS had higher insertion torque and better anchorage than STS in both phases. SDS percent bone–screw contact and inside area bone density were higher in both phases.
Literature
1.
go back to reference Aebi M, Zuber K, Marchesi D (1991) Treatment of cervical spine injuries with anterior plating. Indications, techniques, and results. Spine (Phila Pa 1976) 16:S38–S45CrossRef Aebi M, Zuber K, Marchesi D (1991) Treatment of cervical spine injuries with anterior plating. Indications, techniques, and results. Spine (Phila Pa 1976) 16:S38–S45CrossRef
2.
go back to reference Champy M, Lodde JP, Schmitt R et al (1978) Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg 6:14–21PubMedCrossRef Champy M, Lodde JP, Schmitt R et al (1978) Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg 6:14–21PubMedCrossRef
3.
go back to reference Chapman JR, Harrington RM, Lee KM et al (1996) Factors affecting the pullout strength of cancellous bone screws. J Biomech Eng 118:391–398PubMedCrossRef Chapman JR, Harrington RM, Lee KM et al (1996) Factors affecting the pullout strength of cancellous bone screws. J Biomech Eng 118:391–398PubMedCrossRef
4.
go back to reference Chavassieux P, Pastoureau P, Boivin G et al (1991) Dose effects on ewe bone remodeling of short-term sodium fluoride administration—a histomorphometric and biochemical study. Bone 12:421–427PubMedCrossRef Chavassieux P, Pastoureau P, Boivin G et al (1991) Dose effects on ewe bone remodeling of short-term sodium fluoride administration—a histomorphometric and biochemical study. Bone 12:421–427PubMedCrossRef
5.
go back to reference Conrad BP, Cordista AG, Horodyski M et al (2005) Biomechanical evaluation of the pullout strength of cervical screws. J Spinal Disord Tech 18:506–510PubMedCrossRef Conrad BP, Cordista AG, Horodyski M et al (2005) Biomechanical evaluation of the pullout strength of cervical screws. J Spinal Disord Tech 18:506–510PubMedCrossRef
6.
go back to reference den Boer FC, Patka P, Bakker FC et al (1999) New segmental long bone defect model in sheep: quantitative analysis of healing with dual energy X-ray absorptiometry. J Orthop Res 17:654–660CrossRef den Boer FC, Patka P, Bakker FC et al (1999) New segmental long bone defect model in sheep: quantitative analysis of healing with dual energy X-ray absorptiometry. J Orthop Res 17:654–660CrossRef
7.
go back to reference Ellis JA Jr, Laskin DM (1994) Analysis of seating and fracturing torque of bicortical screws. J Oral Maxillofac Surg 52:483–486PubMedCrossRef Ellis JA Jr, Laskin DM (1994) Analysis of seating and fracturing torque of bicortical screws. J Oral Maxillofac Surg 52:483–486PubMedCrossRef
8.
go back to reference Grubb MR, Currier BL, Shih JS et al (1998) Biomechanical evaluation of anterior cervical spine stabilization. Spine (Phila Pa 1976) 23:886–892CrossRef Grubb MR, Currier BL, Shih JS et al (1998) Biomechanical evaluation of anterior cervical spine stabilization. Spine (Phila Pa 1976) 23:886–892CrossRef
9.
go back to reference Guntermann J, Gellrich NC, Schramm A et al (1998) The Synthes 1.5 and 2.0 self-drilling screws indication in maxillofacial surgery. J Craniomaxillofac Surg 26:65 Guntermann J, Gellrich NC, Schramm A et al (1998) The Synthes 1.5 and 2.0 self-drilling screws indication in maxillofacial surgery. J Craniomaxillofac Surg 26:65
10.
go back to reference Hadjipavlou AG, Nicodemus CL, al-Hamdan FA et al (1997) Correlation of bone equivalent mineral density to pull-out resistance of triangulated pedicle screw construct. J Spinal Disord 10:12–19PubMedCrossRef Hadjipavlou AG, Nicodemus CL, al-Hamdan FA et al (1997) Correlation of bone equivalent mineral density to pull-out resistance of triangulated pedicle screw construct. J Spinal Disord 10:12–19PubMedCrossRef
11.
go back to reference Heidemann W, Gerlach KL (1999) Clinical applications of drill free screws in maxillofacial surgery. J Craniomaxillofac Surg 27:252–255PubMedCrossRef Heidemann W, Gerlach KL (1999) Clinical applications of drill free screws in maxillofacial surgery. J Craniomaxillofac Surg 27:252–255PubMedCrossRef
12.
go back to reference Heidemann W, Gerlach KL, Grobel KH et al (1998) Drill Free Screws: a new form of osteosynthesis screw. J Craniomaxillofac Surg 26:163–168PubMedCrossRef Heidemann W, Gerlach KL, Grobel KH et al (1998) Drill Free Screws: a new form of osteosynthesis screw. J Craniomaxillofac Surg 26:163–168PubMedCrossRef
13.
go back to reference Heidemann W, Terheyden H, Gerlach KL (2001) Analysis of the osseous/metal interface of drill free screws and self-tapping screws. J Craniomaxillofac Surg 29:69–74PubMedCrossRef Heidemann W, Terheyden H, Gerlach KL (2001) Analysis of the osseous/metal interface of drill free screws and self-tapping screws. J Craniomaxillofac Surg 29:69–74PubMedCrossRef
14.
go back to reference Heidemann W, Terheyden H, Gerlach KL (2001) In vivo studies of screw-bone contact of drill-free screws and conventional self-tapping screws. Mund Kiefer Gesichtschir 5:17–21PubMedCrossRef Heidemann W, Terheyden H, Gerlach KL (2001) In vivo studies of screw-bone contact of drill-free screws and conventional self-tapping screws. Mund Kiefer Gesichtschir 5:17–21PubMedCrossRef
15.
go back to reference Hitchon PW, Brenton MD, Coppes JK et al (2003) Factors affecting the pullout strength of self-drilling and self-tapping anterior cervical screws. Spine (Phila Pa 1976) 28:9–13CrossRef Hitchon PW, Brenton MD, Coppes JK et al (2003) Factors affecting the pullout strength of self-drilling and self-tapping anterior cervical screws. Spine (Phila Pa 1976) 28:9–13CrossRef
16.
go back to reference Johnston TL, Karaikovic EE, Lautenschlager EP et al (2006) Cervical pedicle screws vs. lateral mass screws: uniplanar fatigue analysis and residual pullout strengths. Spine J 6:667–672PubMedCrossRef Johnston TL, Karaikovic EE, Lautenschlager EP et al (2006) Cervical pedicle screws vs. lateral mass screws: uniplanar fatigue analysis and residual pullout strengths. Spine J 6:667–672PubMedCrossRef
17.
go back to reference Kaiser MG, Haid RW Jr, Subach BR et al (2002) Anterior cervical plating enhances arthrodesis after discectomy and fusion with cortical allograft. Neurosurgery 50:229–236PubMed Kaiser MG, Haid RW Jr, Subach BR et al (2002) Anterior cervical plating enhances arthrodesis after discectomy and fusion with cortical allograft. Neurosurgery 50:229–236PubMed
18.
go back to reference Liebschner MA (2004) Biomechanical considerations of animal models used in tissue engineering of bone. Biomaterials 25:1697–1714PubMedCrossRef Liebschner MA (2004) Biomechanical considerations of animal models used in tissue engineering of bone. Biomaterials 25:1697–1714PubMedCrossRef
19.
go back to reference Lohr J, Gellrich NC, Buscher P et al (2000) Comparative in vitro studies of self-boring and self-tapping screws. Histomorphological and physical-technical studies of bone layers]. Mund Kiefer Gesichtschir 4:159–163PubMedCrossRef Lohr J, Gellrich NC, Buscher P et al (2000) Comparative in vitro studies of self-boring and self-tapping screws. Histomorphological and physical-technical studies of bone layers]. Mund Kiefer Gesichtschir 4:159–163PubMedCrossRef
20.
go back to reference Mischkowski RA, Kneuertz P, Florvaag B et al (2008) Biomechanical comparison of four different miniscrew types for skeletal anchorage in the mandibulo-maxillary area. Int J Oral Maxillofac Surg 37:948–954PubMedCrossRef Mischkowski RA, Kneuertz P, Florvaag B et al (2008) Biomechanical comparison of four different miniscrew types for skeletal anchorage in the mandibulo-maxillary area. Int J Oral Maxillofac Surg 37:948–954PubMedCrossRef
21.
go back to reference Newman E, Turner AS, Wark JD (1995) The potential of sheep for the study of osteopenia: current status and comparison with other animal models. Bone 16:277S–284SPubMed Newman E, Turner AS, Wark JD (1995) The potential of sheep for the study of osteopenia: current status and comparison with other animal models. Bone 16:277S–284SPubMed
22.
go back to reference Ogon M, Haid C, Krismer M et al (1996) Comparison between single-screw and triangulated, double-screw fixation in anterior spine surgery. A biomechanical test. Spine (Phila Pa 1976) 21:2728–2734CrossRef Ogon M, Haid C, Krismer M et al (1996) Comparison between single-screw and triangulated, double-screw fixation in anterior spine surgery. A biomechanical test. Spine (Phila Pa 1976) 21:2728–2734CrossRef
23.
go back to reference Oktenoglu BT, Ferrara LA, Andalkar N et al (2001) Effects of hole preparation on screw pullout resistance and insertional torque: a biomechanical study. J Neurosurg 94:91–96PubMed Oktenoglu BT, Ferrara LA, Andalkar N et al (2001) Effects of hole preparation on screw pullout resistance and insertional torque: a biomechanical study. J Neurosurg 94:91–96PubMed
24.
go back to reference Omeis I, DeMattia JA, Hillard VH et al (2004) History of instrumentation for stabilization of the subaxial cervical spine. Neurosurg Focus 16:E10PubMedCrossRef Omeis I, DeMattia JA, Hillard VH et al (2004) History of instrumentation for stabilization of the subaxial cervical spine. Neurosurg Focus 16:E10PubMedCrossRef
25.
go back to reference Pastoureau P, Arlot M, Caulin F, Barlet J, Meunier P, Delmas P (1989) Effects of oophorectomy on biochemical and histological indices of bone turnover in ewes. J Bone Miner Res 4:S237, abstract 477 Pastoureau P, Arlot M, Caulin F, Barlet J, Meunier P, Delmas P (1989) Effects of oophorectomy on biochemical and histological indices of bone turnover in ewes. J Bone Miner Res 4:S237, abstract 477
26.
go back to reference Pearce AI, Richards RG, Milz S et al (2007) Animal models for implant biomaterial research in bone: a review. Eur Cell Mater 13:1–10PubMed Pearce AI, Richards RG, Milz S et al (2007) Animal models for implant biomaterial research in bone: a review. Eur Cell Mater 13:1–10PubMed
27.
go back to reference Pitzen T, Barbier D, Tintinger F et al (2002) Screw fixation to the posterior cortical shell does not influence peak torque and pullout in anterior cervical plating. Eur Spine J 11:494–499PubMedCrossRef Pitzen T, Barbier D, Tintinger F et al (2002) Screw fixation to the posterior cortical shell does not influence peak torque and pullout in anterior cervical plating. Eur Spine J 11:494–499PubMedCrossRef
28.
go back to reference Rodriguez-Olaverri JC, Hasharoni A, DeWal H et al (2005) The effect of end screw orientation on the stability of anterior instrumentation in cyclic lateral bending. Spine J 5:554–557PubMedCrossRef Rodriguez-Olaverri JC, Hasharoni A, DeWal H et al (2005) The effect of end screw orientation on the stability of anterior instrumentation in cyclic lateral bending. Spine J 5:554–557PubMedCrossRef
29.
go back to reference Ronderos JF, Jacobowitz R, Sonntag VK et al (1997) Comparative pull-out strength of tapped and untapped pilot holes for bicortical anterior cervical screws. Spine (Phila Pa 1976) 22:167–170CrossRef Ronderos JF, Jacobowitz R, Sonntag VK et al (1997) Comparative pull-out strength of tapped and untapped pilot holes for bicortical anterior cervical screws. Spine (Phila Pa 1976) 22:167–170CrossRef
30.
go back to reference Ruland CM, McAfee PC, Warden KE et al (1991) Triangulation of pedicular instrumentation. A biomechanical analysis. Spine (Phila Pa 1976) 16:S270–S276CrossRef Ruland CM, McAfee PC, Warden KE et al (1991) Triangulation of pedicular instrumentation. A biomechanical analysis. Spine (Phila Pa 1976) 16:S270–S276CrossRef
31.
go back to reference Ryken TC, Clausen JD, Traynelis VC et al (1995) Biomechanical analysis of bone mineral density, insertion technique, screw torque, and holding strength of anterior cervical plate screws. J Neurosurg 83:325–329PubMed Ryken TC, Clausen JD, Traynelis VC et al (1995) Biomechanical analysis of bone mineral density, insertion technique, screw torque, and holding strength of anterior cervical plate screws. J Neurosurg 83:325–329PubMed
32.
go back to reference Ryken TC, Goel VK, Clausen JD, Traynelis VC (1995) Assessment of unicortical and bicortical fixation in a quasistatic cadaveric model. Role of bone mineral density and screw torque. Spine (Phila Pa 1976) 20:1861–1867 Ryken TC, Goel VK, Clausen JD, Traynelis VC (1995) Assessment of unicortical and bicortical fixation in a quasistatic cadaveric model. Role of bone mineral density and screw torque. Spine (Phila Pa 1976) 20:1861–1867
33.
go back to reference Schatzker J, Sanderson R, Murnaghan JP (1975) The holding power of orthopedic screws in vivo. Clin Orthop Relat Res 108:115–126 Schatzker J, Sanderson R, Murnaghan JP (1975) The holding power of orthopedic screws in vivo. Clin Orthop Relat Res 108:115–126
34.
go back to reference Schimming R, Gutwald R, Gellrich N et al (1999) Selfdrilling screws: clinical experiences in cranio- and maxillofacial surgery. Int J Oral Maxillofac Surg 28:26CrossRef Schimming R, Gutwald R, Gellrich N et al (1999) Selfdrilling screws: clinical experiences in cranio- and maxillofacial surgery. Int J Oral Maxillofac Surg 28:26CrossRef
35.
go back to reference Scholz M, Reyes PM, Schleicher P et al (2009) A new stand-alone cervical anterior interbody fusion device: biomechanical comparison with established anterior cervical fixation devices. Spine (Phila Pa 1976) 34:156–160CrossRef Scholz M, Reyes PM, Schleicher P et al (2009) A new stand-alone cervical anterior interbody fusion device: biomechanical comparison with established anterior cervical fixation devices. Spine (Phila Pa 1976) 34:156–160CrossRef
36.
go back to reference Sowden D, Schmitz JP (2002) AO self-drilling and self-tapping screws in rat calvarial bone: an ultrastructural study of the implant interface. J Oral Maxillofac Surg 60:294–299PubMedCrossRef Sowden D, Schmitz JP (2002) AO self-drilling and self-tapping screws in rat calvarial bone: an ultrastructural study of the implant interface. J Oral Maxillofac Surg 60:294–299PubMedCrossRef
37.
go back to reference Su YY, Wilmes B, Honscheid R, Drescher D (2009) Comparison of self-tapping and self-drilling orthodontic mini-implants: an animal study of insertion torque and displacement under lateral loading. Int J Oral Maxillofac Implants 24:404–411PubMed Su YY, Wilmes B, Honscheid R, Drescher D (2009) Comparison of self-tapping and self-drilling orthodontic mini-implants: an animal study of insertion torque and displacement under lateral loading. Int J Oral Maxillofac Implants 24:404–411PubMed
38.
go back to reference Wu X, Deng F, Wang Z et al (2008) Biomechanical and histomorphometric analyses of the osseointegration of microscrews with different surgical techniques in beagle dogs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106:644–650PubMedCrossRef Wu X, Deng F, Wang Z et al (2008) Biomechanical and histomorphometric analyses of the osseointegration of microscrews with different surgical techniques in beagle dogs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106:644–650PubMedCrossRef
Metadata
Title
Experimental in vivo acute and chronic biomechanical and histomorphometrical comparison of self-drilling and self-tapping anterior cervical screws
Authors
Maximiliano Aguiar Porto
Patrícia Silva
Rodrigo Rosa
José Batista Volpon
Antônio Carlos Shimano
Francisco José Albuquerque de Paula
Helton Luiz Aparecido Defino
Publication date
01-05-2012
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 5/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-011-2120-z

Other articles of this Issue 5/2012

European Spine Journal 5/2012 Go to the issue