This article is more than 5 years old. Information may no longer be current.
Craniovertebral junction, subaxial segments contribute to cervical spine growth
Most spinal canal diameter growth occurred in patients by the age of 4 years.
Click Here to Manage Email Alerts
The cervical spine grows vertically across the craniovertebral junction and subaxial segments as children age into their later teenage years, according to study results.
“We thought that we had to define pediatric cervical spine morphometrics throughout all of the childhood ages because, especially in an era where we are instrumenting the spine with increasing frequency, we have to have a handle on what the growth patterns are going to be across the pediatric age,” Cormac O. Maher, MD, professor of neurosurgery at the University of Michigan, told Orthopedics Today. “It matters a great deal if we instrument the spine, especially if we are instrumenting selectively one column or another. We need to know what to expect over the next several years as the child continues to grow.”
Morphometric analysis
Maher and his colleagues separated 1,458 children by sex and age into 34 groups before randomly selecting patients within each group for inclusion until a target of 15 patients in each group had been measured. All patients were between the ages of 1 year and 18 years and underwent a cervical spine CT scan. Researchers performed linear measurements on the mid-sagittal image of the cervical spine in 498 patients.
According to results, normal vertical growth of the pediatric cervical spine continued until 18 years of age in boys and 14 years of age in girls. While the largest single-segment contributor to vertical growth was the C-2 body, subaxial vertebral bodies and disc spaces also contributed to vertical growth. Throughout childhood, there was a dependency on individual vertebral body growth and vertical growth of the disc spaces on overall vertical growth of the cervical spine. By 4 years of age, most of the spinal canal diameter growth occurred in patients, researchers noted.
“The cervical spine growth mimics overall vertical growth of the body, which was expected, but that was nice to see,” Maher said. “About 75% of the vertical growth occurred in the subaxial spine, and I think that was important to see as well. The craniovertebral region was a quarter of the growth, which is a lot, but it is spread out over all segments.”
Patient sample
Although the patient sample was not a true random population sample, Maher noted there may not be a better way of studying the developing cervical spine in pediatric patients since CT scans expose patients to radiation.
“We are never going to order CT scans on normal, random people just to get this information,” Maher said. “On this particular topic, what we are doing now is we are doing a more detailed analysis just at the craniovertebral junction and looking at other morphometric parameters at the craniovertebral junction that we were not able to study in detail in this analysis.” – by Casey Tingle
- Reference:
- Johnson KT, et al. J Neurosurg Pediatr. 2016;doi:10.3171/2016.3.PEDS1612.
- For more information:
- Cormac O. Maher, MD, can be reached at the Department of Neurosurgery, University of Michigan, 1500 E. Medical Center Dr., RM. 3552 Taubman Center, Ann Arbor, MI 48109; email: cmaher@med.umich.edu.
Disclosure: Maher reports no relevant financial disclosures.