Hydroxyapatite dip coated and uncoated titanium poly-axial pedicle screws:: An in vivo bovine model

Study Design. A 1-year-old calf was implanted with titanium pedicle screws either uncoated (n = 7) or coated with hydroxyapatite (n = 7) by the dipping method on the pedicles of vertebrae (t10-I3). Objective. To evaluate biomechanical and histomorphologic responses to titanium pedicle screws uncoated and coated with hydroxyapatite. Summary of Background Data. Failure of fixation caused by loosening of pedicle screws is a problem in spinal surgery. Enhancement of the fixation ability of screws by coating with biocompatible materials may improve prognosis of surgery. Methods. The calf was euthanized 4 months after implantation for determination of insertion and extraction torques for screws, and histologic and scanning electron microscopic examinations of areas screw embedded. Results. Insertion torques did not differ by the kind of screws (99 +/- 5.7 Ncm). However, extraction torques for screws coated with hydroxyapatite were higher than for screws uncoated (249 vs. 133 Ncm, P < 0.01). As compared with uncoated screws, implanted areas for hydroxyapatitecoated screws were denser, had more cracks, and provided better bonding. Fibrous tissue and new bone formation were observed around the areas of uncoated and hydroxyapatitecoated screws embedded, respectively. Conclusions. Hydroxyapatite coating of titanium pedicle screws by the dipping method improved fixation and vertebral bone-implant interface, suggesting a decreased risk of a screw-loosening problem.