Cervical spine standards for flexion radiograph interspinous distance ratios in children

The purpose of this study was to quantitate the interspinous distances in a group of children as they underwent flexion during lateral radiography.

The cases of 59 children with minor trauma who underwent lateral flexion radiography were studied retrospectively. Measurements of each cervical interspinous distance and anteroposterior diameter of the adjacent body were used to calculate a ratio of interspinous distance to vertebral body diameter at each level. Linear regression analyses of each ratio to patient age were performed, and means and standard deviations of the ratios at each level were calculated.

The ratios did not correlate in a statistically significant manner at any level with age. Therefore, data from all 59 children were used to calculate the mean and standard deviation at each cervical level. Most children with severe ligamentous injury who were considered for fusion had interspinous ratios greater than 2 standard deviations above the mean for the control group.

Standards for interspinous distances during flexion by children are presented. These standards may prove to be helpful in the evaluation of children for cervical ligamentous injury.