Radiologic Anatomy of Pediatric Cervicothoracic Junction for Pedicle Screw Surgery

Abstract

Purpose To demonstrate age-dependent changes in dimensions of C6-T3 vertebrae in children for pedicle screw surgery. Methods Radiologic images of 180 pediatric subjects aged 1-18 years were evaluated retrospectively. Results In all vertebrae (C6-T3) at the cervicothoracic junction, the pedicle thickness (p < 0.001), pedicle axis length (p < 0.001), pedicle height (p < 0.001), spinal canal's transverse diameter (p < 0.001), spinal canal's sagittal diameter (p < 0.001) and interpedicular distance (p < 0.001) increased with advancing pediatric age (from one year to 18 years), but the transverse and sagittal pedicle angles decreased (p < 0.001). From C6 to T3, the pedicle axis length (p < 0.001) and sagittal pedicle angle (p < 0.001) increased proportionally, but the spinal canal's transverse diameter (p < 0.001) and transverse pedicle angle (p < 0.001) decreased proportionally. The pedicle height (p < 0.001) decreased from C6 to C7, but then increased until T3. The interpedicular distance (p < 0.001) increased from C6 to C7, but then decreased until T3. The pedicle thickness (p < 0.001) increased from C6 to T1, and then decreased up to T3. The spinal canal's sagittal diameter (p < 0.001) was statistically similar in C6 and C7, but then increased up to T2. Conclusion Our morphometric data regarding vertebral pedicle anatomy located at the cervicothoracic junction may be beneficial for surgeons to form a region-specific clinical strategy in children.