2.2.2. Sufficient contact volume of cortical bone in the screw trajectory
This protocol is extracted from research article:
Anatomical study of the ideal cortical bone trajectory in the lumbar spine
Medicine (Baltimore), Jan 15, 2021; DOI: 10.1097/MD.0000000000024099

The CBT screw fixation strength mainly relies on the interfacial contact with cortical bone. In patients with osteoporosis, the trabecular density is significantly reduced, while the cortical bone is not significantly changed; thus, CBT screws could still provide effective fixation in patients with osteoporosis. Therefore, the contact volume between the cortical bone and CBT screws served as the main factor for evaluating the fixation strength. On the premise of a safe and feasible screw trajectory, the screw fixation strength was related to the contact volume of cortical bone in the screw trajectory; the larger the contact volume, the better the mechanical stability. Therefore, the ideal trajectory should ensure that the screw achieves contact with cortical bone over a sufficiently large volume.

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