Learning objectives
Understanding the normal development of the cervical spine.
Recognizing the normal anatomy and ossification centers of the pediatric cervical spine.
Having a good background about pediatric cervical spine variants and the common pitfalls.
Discuss radiologic appearance of the different pediatric cervical spine fractures.
Background
Radiologic evaluation of the pediatric cervical spine is challenging due to its unique features that make it different from the adult one.
The pediatric cervical spine is characterized by its natural hypermobility,
ligamentous laxity,
and by incomplete ossification of synchondroses and apohpysis.
It differs also in the mechanisms of injury and has a wide range of normal anatomic variants.
These specific features and variants often make emergency radiologic interpretation of the pediatric cervical spine problematic and unfamiliarity with these peculiar properties can lead to faulty...
Findings and procedure details
Development and normal anatomy of the cervical spine:
Chondrification of the vertebral bodies occurs around the fifth or sixth gestational weeks.
Primary ossification centers are present in all the vertebral bodies by the fourth month.
The atlas (C1):
The C1 vertebra has a unique anatomyFig. 1,
three primary ossification centers; one for the anterior arch,
and two for the posterior neural arches separated by synchondroses Fig. 2 .
At birth,
the neural arches are ossified but the anterior arch is not.
The anterior arch undergoes...
Conclusion
Thorough knowledge of the normal radiologic appearance of the pediatric cervical spine,
its unique architecture and normal variants is the best way to avoid misinterpretation of the imaging findings in acute trauma.
Personal information
1.
Manar Maamoun Mohamed Ashour,
Msc
Assistant lecturer of Radiodiagnosis,
Faculty of Medicine,
Ain-Shams university
2.Shaimaa Salah,
MSc
Assistant lecturer of Radiodiagnosis,
Faculty of Medicine,
Ain-Shams university
3.Ayah Mugahid,
MSc
Assistant lecturer of Radiodiagnosis,
Faculty of Medicine,
Ain-Shams university
4.Mona Abou El Ela,
MSc
Assistant lecturer of Radiodiagnosis,
Faculty of Medicine,
Ain-Shams university
5.Abeer Hamed Abdel Hameed Ibrahim,
MD
Assistant lecturer of Radiodiagnosis,
Faculty of Medicine,
Ain-Shams university
References
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Pediatric cervical spine in emergency: radiographic features of normal anatomy,
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An anatomical study of arcuate foramen and its clinical implications: a case report.
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Anderson RC,
Scaife ER,
Fenton SJ,
Kan P,
Hansen KW,
Brockmeyer DL.
Cervical spine clearance after trauma in children.
J Neurosurg.
2006;105:361–364.
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Dowdell J,
Mikhail C,
Robinson J and Allen A....