Morphometric Analysis of Vertebral Growth Using Magnetic Resonance Imaging in the Normal Skeletally Immature Spine

Hong Zhang, Daniel J. Sucato, Pamela Nurenberg, Anna McClung

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Study Design. Morphometic analysis of the thoracic and lumbar pedicle, vertebral body, and spinal canal in the normal infantile and juvenile patients using magnetic resonance imaging (MRI). Objective. To 3-dimensionally characterize the growth of the vertebral column in vivo and define the accurate dynamic growth rate of the normal immature spine. Summary of Background Data. There is a relationship between growth of the spine and the development of spinal deformity. Currently available information regarding vertebral column growth is remarkably limited and poorly defined. The detailed morphologic research is needed to obtain accurate data with regard to growth of the vertebra, including coronal, sagittal, and axial growth information for normal states. Methods. A total of 34 pediatric patients with a normal straight spine who had MRI from thoracic vertebra 1 to lumbar vertebra 5 were assigned to 3 groups: infantile group (n = 11), 0 to 3 years of age; juvenile-young group (n = 16), 4 to 7 years of age; and juvenile-old group (n = 7), 8 to 10 years of age. True transverse and midsagittal MRI images were used for pedicle (width and length), vertebral body (height, depth and width), and spinal canal area measurements. Results. The mean increase of the pedicle width and length was 0.7 mm (16%) and 3.2 mm (18%) from the infantile to the juvenile-young, and was 0.9 mm (15%) and 2.2 mm (11%) through the juvenile-old group. The mean increase of the vertebra body width, depth, and height were 3.6 mm (15%), 4.5 mm (27%), and 3.1 mm (27%), respectively, from the infantile to the juvenile-young, and were 2.9 mm (10%), 1.9 mm (9%) and 2.1 mm (15%), respectively, through the juvenile-old group. The mean increase of the spinal canal area was 41 mm 2 (19%) from the infantile to the juvenile-young and was only 1.8 mm 2 (0.7%) through the juvenile-old group. Conclusion. The current study established the growth of the pedicle, spinal canal, and vertebral body in vivo in a sample of normal pediatric subjects. The vertebral growth rate in the infantile and the juvenile-young period was significantly greater than that in the juvenile-old period. Spinal canal growth is associated with the growth of the pedicle width and has little growth after the juvenile-young period. Pedicle screw fixation would be unlikely to influence the size of the spinal canal after the early juvenile period, but may disturb the pedicle growth in length.

Original languageEnglish (US)
Pages (from-to)133-140
Number of pages8
JournalSpine
Volume43
Issue number2
DOIs
StatePublished - Jan 15 2018

Keywords

  • early onset spinal deformity
  • immature spine
  • vertebral growth

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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