Baker Joseph F
Department of Surgery, University of Auckland, Auckland, New Zealand
Department of Orthopaedic Surgery, Waikato Hospital, Hamilton, New Zealand.
Int J Spine Surg. 2022 Jun;16(3):458-464. doi: 10.14444/8248.
Only a small number of studies have offered normative data for the upper cervical spine in children and with some variation in findings.
The aim of this study was to determine normal values for upper cervical spine measurements used in the assessment of upper cervical spine trauma in the pediatric population.
One-hundred computed tomographic images of the cervical spine of children aged ≤16 years were included for analysis. All children were cleared of spinal injury. Anterior atlanto-dens interval (ADI), posterior atlanto-dens interval (PADI), basion-dens interval (BDI), Powers ratio, condylar-C1 interval (CCI), and lateral mass interval (LMI) were measured on the relevant sagittal or coronal images. Measurements for CCI and LMI were taken on each side.
Mean age was 111 months (range 11-196 months). Sixty-two were male. Mean values (and ranges) of the measurements were as follows: BDI: 7.1 mm (3.6-12.2); ADI 2.8 mm (0.8-4.8); PADI 18.7 mm (14.1-23.2); Powers ratio 0.72 (0.59-1.0); CCI 2.0 and 2.0 (0.5-4.2); and LMI 3.2 and 3.3 mm (1.7-4.8). BDI ( = -0.488), ADI ( = -0.201), PADI ( = 0.264), and CCI ( = -0.468 and -0.454) all showed significant correlation with age. The Powers ratio was the most stable measurement across all age groups.
Normal values were reported from a local pediatric population with a wide age range. Most values correlate with age to a degree, and so normal values may vary throughout childhood. A multicenter study is desirable to advance knowledge in this field.
Current radiographic measures used to assess for possible ligamentous injury in the pediatric upper cervical spine correlate with age. Caution must be held when analyzing the upper cervical spine across a range of age groups in children.
仅有少数研究提供了儿童上颈椎的正常数据，且研究结果存在一定差异。
本研究旨在确定用于评估儿科人群上颈椎创伤的上颈椎测量的正常值。
纳入100例年龄≤16岁儿童的颈椎计算机断层扫描图像进行分析。所有儿童均排除脊柱损伤。在相关矢状面或冠状面图像上测量寰齿前间隙（ADI）、寰齿后间隙（PADI）、颅底至齿突间隙（BDI）、鲍尔斯比率、髁突至C1间隙（CCI）和侧块间隙（LMI）。CCI和LMI的测量在每一侧进行。
平均年龄为111个月（范围11 - 196个月）。62例为男性。测量值的平均值（及范围）如下：BDI：7.1mm（3.6 - 12.2）；ADI 2.8mm（0.8 - 4.8）；PADI 18.7mm（14.1 - 23.2）；鲍尔斯比率0.72（0.59 - 1.0）；CCI 2.0和2.0（0.5 - 4.2）；LMI 3.2和3.3mm（1.7 - 4.8）。BDI（ = -0.488）、ADI（ = -0.201）、PADI（ = 为0.264）和CCI（ = -0.468和 -0.454）均与年龄呈显著相关性。鲍尔斯比率在所有年龄组中是最稳定的测量值。
报告了来自当地年龄范围广泛的儿科人群的正常值。大多数值在一定程度上与年龄相关，因此正常值在整个儿童期可能会有所不同。需要进行多中心研究以推进该领域的知识。
目前用于评估儿科上颈椎可能存在的韧带损伤的影像学测量与年龄相关。在分析不同年龄组儿童的上颈椎时必须谨慎。
