Quantitative analyses of pediatric cervical spine ossification patterns using computed tomography

Yoganandan, Narayan; Pintar, Frank A.; Lew, Sean M.; Rao, Raj D.; Rangarajan, Nagarajan

Affiliations

¹Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA

²Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA

³GESAC Incorporated, Boonsborough, MD, USA

Abstract

The objective of the present study was to quantify ossification processes of the human pediatric cervical spine. Computed tomography images were obtained from a high resolution scanner according to clinical protocols. Bone window images were used to identify the presence of the primary synchondroses of the atlas, axis, and C3 vertebrae in 101 children. Principles of logistic regression were used to determine probability distributions as a function of subject age for each synchondrosis for each vertebra. The mean and 95% upper and 95% lower confidence intervals are given for each dataset delineating probability curves. Posterior ossifications preceded bilateral anterior closures of the synchondroses in all vertebrae. However, ossifications occurred at different ages. Logistic regression results for closures of different synchondrosis indicated pvalues of <0.001 for the atlas, ranging from 0.002 to <0.001 for the axis, and 0.021 to 0.005 for the C3 vertebra. Fifty percent probability of three, two, and one synchondroses occurred at 2.53, 6.97, and 7.57 years of age for the atlas; 3.59, 4.74, and 5.7 years of age for the axis; and 1.28, 2.22, and 3.17 years of age for the third cervical vertebrae, respectively. Ossifications occurring at different ages indicate non-uniform maturations of bone growth/strength. They provide an anatomical rationale to reexamine dummies, scaling processes, and injury metrics for improved understanding of pediatric neck injuries

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Cited By (1)

Year	Entry
2013	Lesire P, Krishnakumar R, Chevalier M-C, Johannsen H, Müller G, Longton A, Kirk A. Safety benefits of the new ECE regulation for the homologation of CRS: an estimation by the EC CASPER project consortium. In: Proceedings of the 23rd International Technical Conference on the Enhanced Safety of Vehicles (ESV). May 27-30, 2013; Seoul, South Korea.