A Morphometric Study Analyzing the Anterior Epidural Space Volume Throughout Childhood

Area of Science:

• Pediatric Spine Anatomy
• Radiology
• Neurosurgery

Background:

• Disc herniations can cause fragments to migrate into the anterior epidural space of the lumbar spine.
• The volume of this space is well-documented in adults but largely unknown in children.

Purpose of the Study:

• To investigate the relative volume of the lumbar anterior epidural space in the growing pediatric spine using imaging studies.
• To compare anterior epidural space volumes across different pediatric age groups.

Main Methods:

• Retrospective chart review of pediatric patients (2018-2020) with lumbar spine CT imaging.
• Stratification of 30 patients into three age groups: 2-5, 10-12, and 16-18 years.
• Measurement of the anterior epidural space using a validated method and statistical analysis (ANOVA, t-test).

Main Results:

• A statistically significant difference in anterior epidural space size was observed across all pediatric age groups and lumbar levels.
• Younger pediatric groups exhibited significantly smaller anterior epidural space volumes compared to older groups.
• Specific age-related differences were noted at L2, L4, and L5 levels, with the 10-12 group smaller than the 16-18 group.

Conclusions:

• The anterior epidural space volume is smaller in the pediatric population compared to adults.
• This reduced space may contribute to the challenges in conservative treatment for pediatric lumbar disc herniations.