Improved bone screws are provided. The bone screws comprise a head portion that is connected to a shaft portion. The shaft portion can comprise one or more fenestrations that extend along a length of the screw. The fenestrations can be straight, or they can include angled bends and arcuate curves. At least a portion of the bone screws can be shot-peened or cold-worked in order to increase the strength of the bone screws to allow for use in, among other regions, the cervical region of the spine.