Woo T D, Tony G, Charran A, Lalam R, Singh J, Tyrrell P N M, Cassar-Pullicino V N
Royal Stoke University Hospital, University Hospitals North Midlands NHS Trust, Newcastle Road, Newcastle-under-Lyme, Stoke-on-Trent, Staffordshire, UK.
Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Twmpath Lane, Gobowen, Oswestry, Shropshire, UK.
Skeletal Radiol. 2018 Sep;47(9):1221-1228. doi: 10.1007/s00256-018-2909-5. Epub 2018 Mar 1.
The ring apophyses of the cervical spine have a variable appearance that changes with age. The times at which they appear and fuse at each level are not fixed. In this study, we aim to detail normal ranges of appearance of these ossification centers for each age group.
One hundred and eighty patients under the age of 21 attending the Royal Stoke University Hospital for cervical spine radiographs were retrospectively identified. The presence or absence of ring apophyses at each cervical level and whether these had undergone fusion was reported, as were the thickness, length, and craniocaudal and anteroposterior distance of the apophysis from the vertebral body. The angulation of the apophysis relative to the endplate was also noted.
The youngest patient in which apophyses were seen was aged 3, but apophyses were otherwise rarely seen before the age of 6. All apophyses were present from age 14, and the superior apophyses fused by the age of 18, although unfused inferior apophyses were still seen in the 20-year age group. It was observed that apophyses were rarely separated from the vertebral body by greater than 1 mm in craniocaudal distance (1%) or 2.5 mm in anteroposterior distance (2.6%) and the anterior apophysis was angulated towards the endplate in only 1% of cases.
We have detailed the range of normal appearances of the ring apophyses of the developing cervical spine. Cervical spine apophyseal injury is thought to be rare, but knowledge of normative morphological features should help in this diagnosis.
颈椎的环状突有多种外观表现，且会随年龄变化。它们在每个节段出现和融合的时间并不固定。在本研究中，我们旨在详细阐述各年龄组这些骨化中心的正常出现范围。
回顾性纳入了180例21岁以下在皇家斯托克大学医院接受颈椎X线检查的患者。报告了每个颈椎节段环状突的有无及其是否已融合，以及突与椎体的厚度、长度、头尾向和前后距离。还记录了突相对于终板的角度。
观察到环状突的最年轻患者为3岁，但6岁前很少见。14岁时所有环状突均已出现，上环状突在18岁时融合，不过在20岁年龄组中仍可见未融合的下环状突。观察发现，环状突与椎体在头尾向距离上很少分离超过1毫米（1%），在前后距离上很少分离超过2.5毫米（2.6%），且仅1%的病例中前突向终板成角。
我们详细阐述了发育中颈椎环状突的正常外观范围。颈椎突损伤被认为较为罕见，但了解正常形态特征有助于诊断。
