J Korean Neurosurg Soc.  2015 Mar;57(3):185-191. 10.3340/jkns.2015.57.3.185.

Quantification of Pediatric Cervical Growth: Anatomical Changes in the Sub-Axial Spine

• Lee HJ
• Lee JJ
• Hong JT
• Kim JT

• KMID: 2191219
• DOI: http://doi.org/10.3340/jkns.2015.57.3.185

Abstract

OBJECTIVE
In order to provide normal values of the pediatric sub-axial cervical spinal canal and vertebral body growth pattern using computed tomographic scans, a total of 318 patients less than 10 years old were included.
METHODS
The growth of the vertebral body and canal space was investigated using four different age groups. The Torg ratio (TR) was calculated and all patients were classified into a low TR group and a high TR group according to a cutoff value of 1.0. To account for spinal curvature, the C3-7 angle was measured.
RESULTS
Very little axial expansion and growth in height were observed (2.9 mm and 3.4 mm, respectively), and the spinal canal increments (1.8 mm) were much smaller than the dimensions of the vertebral body. The mean TR values were 1.03+/-0.14 at the C3 vertebral level, 1.02+/-0.13 at C4, 1.05+/-0.13 at C5, 1.04+/-0.13 at C6, and 1.02+/-0.12 at C7 in all patients. The mean sub-axial angle (C3-7) was 7.9+/-10.6degrees (range: -17-47degrees).
CONCLUSION
The upper sub-axial spinal canal continuously increased in size compared to the lower sub-axial spine after 8 years of age. Considerable decrements in the TR was found after late childhood compared to younger ages. Generally, there were no significant differences between boys and girls in vertical length of the cervical vertebrae. However, the axial dimension of the vertebral body and the spinal canal space varied according to gender.

Keyword

Pediatric cervical growth; Vertebral body; Spinal canal space; Torg ratio

MeSH Terms

Cervical Vertebrae
Female
Humans
Reference Values
Spinal Canal
Spinal Curvatures
Spine*

Figure

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  Fig. 1 Vertebral body antero-posterior diameter (arrow in the vertebral body) and spinal canal antero-posterior diameter were measured (A). Vertebral body height (arrow in the vertebral body) and the C3-7 angles were measured (B).

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  Fig. 2 The growth of VBH occurred in a straight fashion. B: The growth of vertebral body axial diameter was minimized between the VE and the E groups. C: Generally the expansion of canal space restricted after 5 years old age, however the middle upper cervical vertebrae (C3, 4) continuously increased after 8 years old age. VBH: vertebral body height, VBAP: vertebral body antero-posterior diameter, SCAP: spinal canal antero-posterior diameter.

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