Impact of bone quality on the performance of integrated fixation cage screws

Our findings indicate that bone quality in the vertebral body varied spatially depending on the orientation and the insertion location of the IFC screw. These alterations in local bone quality significantly affected the screw's ability to fixate to bone. These variations in bone quality may be assessed intraoperatively using screw insertional torque measurements. By understanding available bone purchase at the bone-implant interface, the appropriate implant design can be selected to maximize the fixation strength.