A bone fusion screw comprises a hollow elongated body having a longitudinal axis extending between a proximal end and an open distal tip. The body defines an inner chamber bounded by an inner surface of the body extending between the proximal end and the distal tip. The body includes threads formed along at least a portion of the outer surface. At least one wedge-shaped tooth extends axially distally from the distal tip. The tooth comprises a cutting edge for cutting bone as the body is rotated. An intermediate fluted portion adjacent the distal tip comprises at least one flute. The flute has a first end adjacent the tooth at the distal tip for assisting removal of bone cuttings from the cutting edge and a second end intersecting the threads along the body. The body defines a plurality of apertures opening into the chamber.