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Quantitative analyses of pediatric cervical spine ossification patterns using computed tomography.

Narayan Yoganandan¹, Frank A Pintar, Sean M Lew

¹Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA GESAC Incorporated, Boonsborough, MD, USA.

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|November 23, 2011

Summary

This study quantified pediatric cervical spine ossification using CT scans in 101 children. Findings reveal non-uniform bone maturation, crucial for understanding pediatric neck injury risks.

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Area of Science:

Orthopedics
Pediatric Imaging
Forensic Anthropology

Background:

The pediatric cervical spine undergoes complex ossification processes.
Understanding these developmental changes is vital for injury assessment.

Purpose of the Study:

To quantify the ossification timing of primary synchondroses in the pediatric cervical spine (atlas, axis, C3).
To establish age-based probability distributions for synchondrosis closure.
To provide an anatomical basis for improving pediatric neck injury research.

Main Methods:

High-resolution computed tomography (CT) scans of 101 children were analyzed.
Bone window images identified primary synchondroses of the atlas, axis, and C3 vertebrae.
Logistic regression modeled probability distributions of synchondrosis closure as a function of age.

Main Results:

Posterior ossification consistently preceded anterior closure across all studied vertebrae.
Significant logistic regression models (p<0.05) were found for all synchondroses.
Fifty percent probability of closure for specific synchondroses occurred at various ages, e.g., atlas (2.53-7.57 years), axis (3.59-5.7 years), C3 (1.28-3.17 years).

Conclusions:

Ossification timing varies significantly between different synchondroses and vertebrae.
These age-related ossification patterns indicate non-uniform maturation of bone growth and strength.
The findings support re-evaluating anthropomorphic test devices, scaling methods, and injury metrics for pediatric neck trauma.