title: Morphometric analysis of the developing pediatric cervical spine.
abstract: OBJECTIVE Our understanding of pediatric cervical spine development remains incomplete. The purpose of this analysis was to quantitatively define cervical spine growth in a population of children with normal CT scans. METHODS A total of 1458 children older than 1 year and younger than 18 years of age who had undergone a cervical spine CT scan at the authors' institution were identified. Subjects were separated by sex and age (in years) into 34 groups. Following this assignment, subjects within each group were randomly selected for inclusion until a target of 15 subjects in each group had been measured. Linear measurements were performed on the midsagittal image of the cervical spine. Twenty-three unique measurements were obtained for each subject. RESULTS Data showed that normal vertical growth of the pediatric cervical spine continues up to 18 years of age in boys and 14 years of age in girls. Approximately 75% of the vertical growth occurs throughout the subaxial spine and 25% occurs across the craniovertebral region. The C-2 body is the largest single-segment contributor to vertical growth, but the subaxial vertebral bodies and disc spaces also contribute. Overall vertical growth of the cervical spine throughout childhood is dependent on individual vertebral body growth as well as vertical growth of the disc spaces. The majority of spinal canal diameter growth occurs by 4 years of age. CONCLUSIONS The authors' morphometric analyses establish parameters for normal pediatric cervical spine growth up to 18 years of age. These data should be considered when evaluating children for potential surgical intervention and provide a basis of comparison for studies investigating the effects of cervical spine instrumentation and fusion on subsequent growth.
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Kyle T
authors.initials: KT
authors.lastname: Johnson
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Wajd N
authors.initials: WN
authors.lastname: Al-Holou
authors.affiliation: Department of Neurosurgery, Columbia University, New York, New York.
authors.forename: Richard C E
authors.initials: RC
authors.lastname: Anderson
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wilson
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Tejas
authors.initials: T
authors.lastname: Karnati
authors.affiliation: Radiology, University of Michigan, Ann Arbor, Michigan; and.
authors.forename: Mohannad
authors.initials: M
authors.lastname: Ibrahim
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Hugh J L
authors.initials: HJ
authors.lastname: Garton
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Cormac O
authors.initials: CO
authors.lastname: Maher
mesh_terms: D000293:Adolescent; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000254:growth & development*; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012727:Sex Characteristics; D014057:Tomography, X-Ray Computed
keywords: D2–D7 = depth of vertebral bodies C2–C7; H2–H7 = height of C2–C7 vertebral bodies; IVD = intervertebral disc; LA = distance from the basion to the midpoint of the inferior surface of the C-7 body; LB = distance from the most superior aspect of the dens to the midpoint of the inferior surface of the C-7 body; LC = distance from the midpoint of the inferior surface of the C-2 body to the midpoint of the inferior surface of the C-7 body; LD = distance from the basion to the midpoint of the inferior surface of the C-2 body; PACS = picture archiving and communications system; SC2 = upper cervical canal diameter measured at the level of the C-2 body; SC7 = lower cervical canal diameter measured at the level of the C-7 body; cervical spine; development; growth; morphometric