Related Experiment Video
Updated: Apr 13, 2026
Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Quantification of pediatric cervical spine growth at the cranio-vertebral junction
Ho Jin Lee1, Jong Tae Kim1, Myoung Hoon Shin1
1Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.
Insights
Spinal canal expansion at the craniovertebral junction (CVJ) is limited to early childhood. While C2 body and odontoid growth continues, the McRae line shows minimal change with age.
Area of Science:
- Pediatric Radiology
- Anatomy
- Biomedical Engineering
Background:
- The craniovertebral junction (CVJ) is a complex anatomical region crucial for spinal cord protection.
- Understanding morphological changes in the CVJ during pediatric development is essential for diagnosing and managing related conditions.
Purpose of the Study:
- To investigate age-related morphological changes in the craniovertebral junction (CVJ) using computed tomography (CT).
Main Methods:
- A CT-based study included 238 pediatric patients (mean age 47.8 months).
- Key parameters measured included spinal canal diameter, Power's ratio, McRae line, C1 ring height, atlantoaxial joint space, C2 growth, and distances related to the dens (M-PB-C2, B-C2).
- Patients were grouped into infancy (≤2 years), very early childhood (2-5 years), and early childhood (≥5 years).
Main Results:
- Spinal canal diameter significantly increased up to very early childhood (≤5 years) but showed no significant increase thereafter.
- All C2 body and odontoid process parameters demonstrated significant age-related differences (p<0.05).
- The McRae line decreased with age (8.5mm in infancy, 8mm in very early, 7.5mm in early childhood), and the M-PB-C2 line exhibited dynamic changes.
Conclusions:
- Spinal canal expansion in the CVJ region is primarily confined to the first five years of life.
- Continuous growth of the C2 body and odontoid process occurs throughout childhood, influencing CVJ morphology.
- Despite ongoing C2 growth, the McRae line shows limited change, indicating a complex developmental pattern in the CVJ.
Objective:
The purpose of this study was to investigate morphological change at the craniovertebral junction (CVJ) region using computed tomography.
Methods:
A total of 238 patients were included in this study, and mean age was 47.8±21.3 months. Spinal canal diameter, Power's ratio, McRae line, antero-posterior C1 ring height, atlantoaxial joint space, C2 growth, epidural space from the dens (M-PB-C2) and longitudinal distance (basion to C2 lower margin, B-C2) were measured. The mean value of each parameter was assessed for individual age groups. The cohorts were then divided into three larger age groups : infancy (I) (≤2 years), very early (VE) childhood (2-5 years) and early (E) childhood (5≥ years).
Results:
Spinal canal diameter increased with age; however, this value did not increase with statistical significance after VE age. A significant age-related difference was found for all C2 body and odontoid parameters (p<0.05). Mean McRae line was 8.5, 8, and 7.5 mm in the I, VE, and E groups, respectively. The M-PB-C2 line showed up-and-down dynamic change during early pediatric periods.
Conclusion:
Expansion of the spinal canal was restricted to the very early childhood period (less than 5 years) in the CVJ region; however, the C2 body and odontoid process increased continuously with age. The above results induced a dynamic change in the M-PB-C2 line. Although C2 longitudinal growth continued with age, the McRae line showed relatively little change.
More Related Videos
12:59Three and Four-Dimensional Visualization and Analysis Approaches to Study Vertebrate Axial Elongation and Segmentation
Published on: February 28, 2021
07:01Clinical Efficacy of Ultrasound-Assisted Scoliosis-Specific Exercise in Mild-Grade Adolescent Idiopathic Scoliosis
Published on: December 2, 2025
Related Concept Videos
01:16Vertebral Column: Regions and Curvature
Regions of the Vertebral Column
In an adult, the spine is subdivided into five regions: the cervical, the thoracic, the lumbar, the sacral, and the coccygeal region. The spine initially develops as a series of 33 vertebrae; after 20 years of age, the nine bones in the sacral region, five sacral, and four coccygeal bones fuse to form...
01:27Cranial Bones: Lateral View
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...
01:22Sutures of the Skull
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...
01:14Cranial Bones: Superior and Posterior View
The frontal bone is the single bone that forms the forehead. At its anterior midline, between the eyebrows, there is a slight depression called the glabella. The frontal bone also forms the supraorbital margin of the orbit. Near the middle of this margin is the supraorbital foramen, the opening that provides passage for a sensory nerve to the forehead. The frontal bone is thickened just above each supraorbital margin,...
01:27Growth of Cartilage and Bone Tissue
01:19Cranial and Spinal Meninges
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...