title: Age- and gender-related changes in pediatric thoracic vertebral morphology.
abstract: BACKGROUND
  Although it is well known that the growth of thoracic spine changes significantly with age, gender, and vertebral level in the skeletally normal pediatric population, there have been very few studies attempting to comprehensively quantify such variations. Biomechanical and computational models of the growing thoracic spine have provided insight into safety and efficacy of surgical and noninvasive treatments for spinal deformity. However, many of these models only consider growth of the vertebral body and pedicles and assume a consistent growth rate for these structures across thoracic levels.
  
  
  OBJECTIVE
  To enhance the understanding of age-, gender-, and level-related growth dynamics of the pediatric thoracic spine by comprehensively quantifying the thoracic vertebral morphology for subjects between 1 and 19 years.
  
  
  METHODS
  A retrospective computed tomography (CT) image analysis study.
  
  
  METHODS
  Retrospectively obtained chest CT scans from 100 skeletally normal pediatric subjects (45 males and 55 females between the ages 1 and 19 years) were digitally reconstructed using medical imaging software. Surface point clouds of thoracic vertebrae were extracted and 26 vertebral geometry parameters were measured using 25 semiautomatically identified surface landmarks and anatomical slices from each thoracic vertebra (T1-T12). Data were assessed for normality, symmetry, and age-, gender-, and level-related differences in geometric measures and growth. Linear regression was performed to estimate of the rates of variation with age for each measurement.
  
  
  RESULTS
  Asymmetries (bilateral, superior-inferior, and anteroposterior) were observed in vertebral body heights, end plate widths and depths, and interfacet widths. Within genders, significant interlevel differences were observed for all geometric measures, and significant differences in the rates of growth were found across thoracic levels for most parameters. Significant differences were observed between genders for pedicle, spinous process, and facet measurements. Growth rates of the pedicles and vertebral bodies were also found to vary significantly between genders.
  
  
  CONCLUSIONS
  The rates of growth for most thoracic vertebral structures varied between genders and across vertebral levels. These growth rates followed trends similar to those of their associated vertebral dimensions and this indicates that, across levels and between genders, larger vertebral structures grow at faster rates, whereas smaller structures grow at a slower rate. Such level- and gender-specific information could be used to inform clinical decisions about spinal deformity treatment and adapted for use in biomechanical and computational modeling of thoracic growth and growth modulation.
authors: School of Biomedical Engineering, Science and Health Systems, Drexel University, 3141 Chestnut St, Bossone 718, Philadelphia, PA 19104, USA.
authors: James R
authors: JR
authors: Peters
authors: School of Biomedical Engineering, Science and Health Systems, Drexel University, 3141 Chestnut St, Bossone 718, Philadelphia, PA 19104, USA.
authors: Charanya
authors: C
authors: Chandrasekaran
authors: Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Nesbitt Hall, 3215 Market St. Philadelphia, PA 19104, USA.
authors: Lucy F
authors: LF
authors: Robinson
authors: Department of Radiology, The Children's Hospital of Philadelphia, 34th St and Civic Center Boulevard, Philadelphia, PA 19104, USA.
authors: Sabah E
authors: SE
authors: Servaes
authors: Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, 34th St and Civic Center Boulevard, Philadelphia, PA 19104, USA.
authors: Robert M
authors: RM
authors: Campbell
authors: School of Biomedical Engineering, Science and Health Systems, Drexel University, 3141 Chestnut St, Bossone 718, Philadelphia, PA 19104, USA. Electronic address: sri.bala@drexel.edu.
authors: Sriram
authors: S
authors: Balasubramanian
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012737:Sex Factors; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000254:growth & development*; D014057:Tomography, X-Ray Computed
keywords: Growth; Morphology; Pediatric; Spine; Thoracic; Vertebra