Anatomy Analysis of C5 CT Images in Children Aged 1-14 Years

There is a lack of large-scale anatomical studies on children's C5 vertebrae, and experience with posterior cervical spine fixation surgery in children is limited, posing challenging clinical issues. This study aims to investigate the size, morphology, and developmental growth of the C5 pedicle and lateral mass in children under 14 years of age, and to assess the feasibility of screw placement.

We collected CT image data of children aged 1-14 years who underwent cervical spine CT scans at our hospital from June 2018 to June 2020, measured the imaging anatomy of C5 vertebral arches and lateral masses. The t-test was used for difference testing and the least squares method was used for fit analysis.

The C5 vertebral arches and lateral masses in children increase in size with age, with varying growth rates, initially rapid, then slow in the middle, and rapid again later. In children aged 2-3 years, the C5 pedicle width is 3.56 ± 0.34 mm, and the lateral mass height is 3.84 ± 0.37 mm, allowing for the use of a 3.5 mm diameter pedicle and lateral mass screw in children over 3 years old. Among children aged 1-14 years, the average values of angles A, C, and E show relatively small fluctuations, indicating stable anatomical structures, while angle D significantly increases with age. Fitting analysis results reveal that the various parameters are mainly correlated with power curves, including both quadratic and cubic curves.

In children over 3 years old, both the C5 pedicle and lateral mass reach a diameter of over 3.5 mm, allowing for the placement of a 3.5 mm screw. Preoperative thin-section CT scans and careful measurement of various anatomical parameters are essential. This study provides specific imaging anatomical parameters for the C5 pedicle and lateral mass in children, serving as a morphological anatomical reference for posterior cervical spine fixation surgery and designing pediatric posterior cervical spine screws.