Developmental morphology and ossification patterns of the C1 vertebra
Raj D Rao1, Shujie Tang, Chi Lim
1Department of Orthopaedic Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
The Journal of Bone and Joint Surgery. American Volume
|September 6, 2013
Summary
The first cervical vertebra (C1) synchondroses close by age three, with most growth occurring by age six. This study details C1 development in children, aiding in distinguishing fractures from normal ossification.
Area of Science:
- Pediatric radiology
- Orthopedic anatomy
- Developmental biology
Background:
- The first cervical vertebra (C1) is a unique, ring-shaped structure, predominantly cartilaginous at birth.
- Understanding C1 development is crucial for diagnosing pediatric cervical spine injuries.
Purpose of the Study:
- To retrospectively analyze the age of synchondroses closure in C1.
- To determine age-dependent morphological characteristics of the C1 vertebra using CT scans.
Main Methods:
- Retrospective analysis of helical CT scans from 54 children (infancy to 18 years).
- Measurement of anterior and posterior synchondroses widths, diameters, spinal canal area, and arch heights.
- Evaluation of parameter variations across different age groups.
Main Results:
- Posterior synchondrosis closure was complete by 36 months; anterior synchondrosis closure generally occurred after 36 months.
- Significant growth in C1 diameters and canal area occurred up to age 3-6 years, with minimal changes thereafter.
- Inner transverse diameter remained constant, while ring heights increased until age 9-12 years.
Conclusions:
- CT data provides insights into age-dependent C1 anatomy and biomechanical stability in children.
- Findings assist in differentiating C1 fractures from incomplete ossification.
- Results aid in clinical decision-making regarding C1 internal fixation in pediatric patients.
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