Normal sagittal diameter and variation in the pediatric cervical spine

Area of Science:

• Anatomy
• Radiology
• Pediatric Imaging

Background:

• Traditional evaluation of cervical spinal canal sagittal diameter focuses on suspected expansile intraspinal lesions.
• Previous studies suggest a gradual decrease in sagittal diameter from C1 to C7 or C1 to C3, with plateauing from C4 to C7 in adults.
• Understanding normal variations is crucial for accurate diagnosis and interpretation of spinal imaging.

Purpose of the Study:

• To investigate the normal sagittal diameter of the cervical spinal canal in children and adolescents.
• To identify variations in cervical spinal canal morphology in young individuals without spinal cord lesions.
• To discuss the developmental changes leading to the adult funnel-shaped cervical canal.

Main Methods:

• Retrospective analysis of cervical spine imaging in 158 young individuals.
• Exclusion of participants with evidence of cervical cord lesions.
• Measurement of sagittal diameters at various cervical levels (C1-C7).

Main Results:

• Gradual widening of the lower cervical spinal canal was frequently observed in normal children up to 10 years old.
• Mid-canal ballooning was also noted in younger children and occasionally in individuals up to 18 years of age.
• These findings differ from the typically described adult canal morphology.

Conclusions:

• The normal cervical spinal canal in children exhibits significant variability, including widening and ballooning, which differs from adult patterns.
• These variations represent normal developmental changes rather than pathological findings.
• The study contributes to a better understanding of the pediatric cervical spine's morphology and its evolution into the adult form.