Neck extension as a cause of SIDS

The intradural sagittal diameter at the second cervical vertebra (SD/C2) of 62 SIDS cases was measured myelographically. This SD/C2 proved to be dependent on body size, body weight, and age. A clear, age-dependent difference is to be found in the primarily narrow spinal canal. This parameter (SD/C2), which is more precisely defined in adults on the basis of clinical, radiological, and autopsical findings is assumed to have the value of 0.5 cm in the first 2 months, 0.6 cm in the third month, and 0.65 cm in the fourth month. The resulting potential danger to infants is dependent upon their position. The SD/C2, was significantly decreased in extension as compared to a neutral posture. With consideration of the primarily narrow spinal canal in the infant, there is, according to our measurements, a potential hazard for the infant in any further, significant shortening of the SD/C2. This is independent of the width of the spinal canal under maximal extension. We found individual cases in which the SD/C2 was decreased by almost 50% from the normal value in neutral position. No correlation was found between the primary width of the spinal canal and the degree of luminal reduction upon extension.