Abstract
Screw loosening is a common complication of pedicle screw internal fixation surgery. This study aimed to investigate whether the application of a porous scaffold structure can increase the contact area between screws and bone tissue by comparing the bone ingrowth and screw-bone interface of porous scaffold core pedicle screws (PSCPSs) and hollow lateral hole pedicle screws (HLHPSs) in the lumbar spine of Bama pigs. Sixteen pedicle screws of both types were implanted into the bilateral pedicles of the L1-4 vertebrae of two Bama pigs. All Bama pigs were sacrificed and the lumbar spine was freed into individual vertebrae at 16 weeks postoperatively. After the vertebrae were made into screw-centered specimens, micro-computed tomography (micro-CT) analysis and histological observation were performed to assess the screw-bone interface and bone growth around and within the screws. We found that the bone condition around PSCPSs and HLHPSs did not show significant differences on micro-CT three-dimensional reconstruction images. CT transverse views showed different bone growth inside the two screws. In PSCPSs, bone tissue was seen to fill the internal pores and was evenly distributed around each strut. Inside HLHPSs, bone growth was confined to one side of the screw and did not fill the entire cavity. Osteometric analysis showed that bone volume fraction (BVF) and trabecular number (Tb.N), the parameters representing bone mass, were higher in PSCPSs than in HLHPSs. These differences were not statistically significant (P>0.05). Histological observations visualized that the osseointegration within PSCPSs was superior to that of HLHPSs, and the tight integration of bone tissue with the porous scaffold resulted in a larger screw-bone integration area in PSCPSs than in HLHPSs. Compared with HLHPSs, PSCPSs possessing a porous scaffold core could promote bone ingrowth and osseointegration, resulting in an effective enhancement of the combined area of the screw-bone interface.
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