Cortical bone trajectory screws supporting a spine.

Back Pain Breakthrough: How a New Screw Technique Could Fix Spinal Fractures

Jordan Keane in Health & Wellness August 2025 • 4 min read.

"Could cortical bone trajectory screws offer a better solution for osteoporotic compression fractures and progressive hyperkyphosis?"

Back pain can be a real nightmare, especially when it stems from something serious like a spinal fracture. Osteoporosis, a condition that weakens bones, makes these fractures more likely. When these fractures lead to progressive hyperkyphosis—that hunched-back appearance—it can seriously impact your quality of life. Traditional treatments sometimes fall short, leaving people searching for better options.

Fortunately, there's a promising technique on the horizon: cortical bone trajectory (CBT) screws. This method offers a new way to stabilize the spine, particularly in cases where osteoporosis is a factor. The big question is, can these CBT screws really make a difference, offering more stability and a better outcome for those with spinal fractures and hyperkyphosis?

A recent case report sheds light on this innovative approach, detailing how CBT screws were used to treat a woman with an osteoporotic compression fracture. The results suggest that this technique could be a game-changer, providing improved stability and correction of spinal deformities. Let’s dive into the details and see what this could mean for the future of spinal care.

What are Cortical Bone Trajectory Screws and Why Are They a Big Deal?

Cortical bone trajectory screws supporting a spine.

Cortical bone trajectory (CBT) screws are a special type of screw used in spinal surgery. Unlike traditional screws that go straight into the bone, CBT screws follow a different path, aiming to grab the stronger, outer layer of the bone, known as the cortex. This is particularly helpful for people with osteoporosis, where the inner bone is weaker and doesn't hold screws as well.

So, why is this such a big deal? Well, think of it like building a fence. If the posts are loosely set in soft ground, the fence won't stand for long. Similarly, if spinal screws don't have a good grip, they can loosen, leading to more problems. CBT screws, by anchoring into the stronger cortical bone, provide a more solid foundation, reducing the risk of screw loosening and improving the overall stability of the spine.

Stronger Anchor: CBT screws grip the denser cortical bone.
Reduced Loosening: Less risk of screws coming loose, especially in osteoporotic bone.
Improved Stability: Provides a more solid foundation for spinal correction.

The case report we mentioned earlier involved a 70-year-old woman who had an osteoporotic compression fracture. She had already undergone a vertebroplasty (a procedure to stabilize the fracture) and screw fixation, but unfortunately, the screws loosened, and she developed another fracture. This is where CBT screws came in. The surgeons used CBT screws for a long-segment posterior fixation after performing an anterior vertebral column resection (a procedure to remove a portion of the damaged vertebra). The results were promising. After one year, her spinal alignment had improved significantly, and she was able to walk without a walker.

The Future of Spinal Fracture Treatment

The findings from this case report suggest that cortical bone trajectory screws could be a valuable tool in treating osteoporotic compression fractures and progressive hyperkyphosis. By providing a more stable anchor in the bone, CBT screws may reduce the risk of screw loosening and improve overall spinal alignment. While more research is needed to confirm these benefits, this technique offers hope for those seeking relief from back pain and improved quality of life. If you're dealing with spinal issues, it's worth discussing with your doctor whether CBT screws might be a suitable option for you.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.inat.2018.10.008, Alternate LINK

Title: Using The Cortical Bone Trajectory Screw Technique With Vertebral Column Resection To Treat An Osteoporotic Compression Fracture In Progressive Thoracolumbar Hyperkyphosis: A Case Report

Subject: Neurology (clinical)

Journal: Interdisciplinary Neurosurgery

Publisher: Elsevier BV

Authors: Chia-Hung Chao, Cheng-Yang Hsieh, Yu-Feng Su, Aij-Lie Kwan

Published: 2019-03-01

Everything You Need To Know

What are Cortical Bone Trajectory (CBT) screws?

Cortical bone trajectory (CBT) screws are a specialized type of screw used in spinal surgery. They are designed to follow a different path compared to traditional screws. Instead of going straight into the bone, CBT screws are aimed to grip the stronger, outer layer of the bone, known as the cortex. This is particularly beneficial in cases where osteoporosis is present because the inner bone is weaker and doesn't hold screws as effectively.

Why is osteoporosis relevant to spinal fractures and treatment?

Osteoporosis is a condition that weakens bones, making spinal fractures more likely. These fractures can lead to progressive hyperkyphosis, which is a hunched-back appearance. The significance lies in the impact on a person's quality of life. Traditional treatments may not always provide adequate stability, making innovative solutions like cortical bone trajectory (CBT) screws a promising option. CBT screws offer a more secure anchor in the bone, reducing the risk of screw loosening and improving spinal alignment, which is crucial for managing fractures and hyperkyphosis.

What are the implications of using the Cortical Bone Trajectory (CBT) screw technique?

The cortical bone trajectory (CBT) screw technique provides a more solid foundation for spinal correction, especially in patients with osteoporosis. This technique improves the overall stability of the spine by reducing the risk of screw loosening, which is a common issue with traditional screws in osteoporotic bone. The implications include improved spinal alignment, better outcomes for osteoporotic compression fractures, and an enhanced quality of life for those suffering from progressive hyperkyphosis. The use of CBT screws represents a step forward in spinal care, offering new hope for those seeking relief from back pain and spinal deformities.

How effective are Cortical Bone Trajectory (CBT) screws based on the reported case?

A case report highlighted the successful use of cortical bone trajectory (CBT) screws in a 70-year-old woman with an osteoporotic compression fracture. She had previously undergone vertebroplasty and screw fixation, but the screws loosened, leading to another fracture. Surgeons used CBT screws for a long-segment posterior fixation after an anterior vertebral column resection. After one year, the patient's spinal alignment improved significantly, and she could walk without a walker. This outcome demonstrates the potential of CBT screws to improve spinal stability and correct deformities, especially in challenging cases where traditional methods failed.

How do I know if Cortical Bone Trajectory (CBT) screws are right for me?

If you are dealing with spinal issues, it's best to discuss treatment options with your doctor. Cortical bone trajectory (CBT) screws might be a suitable option if you have osteoporotic compression fractures or progressive hyperkyphosis. Your doctor can evaluate your condition, considering factors like the severity of the fracture and the presence of osteoporosis, to determine if CBT screws could provide improved stability and better outcomes. CBT screws are a specialized technique, and not every case will be suitable. The best treatment plan is customized to your individual needs and medical history.