Title : Paediatric cervical spine development and ethnic variation: A CT based study from a New Zealand cohort
Abstract:
Study Design: Retrospective radiologic study.
Purpose: To define the sub-axial cervical spine dimensions in a paediatric cohort and assess influence of ethnicity.
Overview of Literature: Variation in cervical spine dimensions is linked to the risk of myelopathy or spinal cord injury. Previous studies have reported ethnic differences in adult canal dimensions, either as absolute values or canal: Vertebral Body (VB) ratios. However, data on children is limited.
Methods: CT scans of children <18 years (excluding pathology) were assessed for anteroposterior (AP) and transverse VB and canal dimensions at the mid-pedicle level, and canal:VB ratios calculated. Correlation and ANCOVA analyses compared findings between New Zealand European (NZE) and M?ori.
Results: 111 patients were assessed (63 NZE, 48 M?ori). VB and canal dimensions were larger in NZE, however canal: VB ratios were smaller in NZE (significant at C7 only, p=0.011).
Age correlated strongly with mean VB AP diameter and moderately with canal: VB ratio. ANCOVA showed ethnicity (NZE) significantly predicted VB dimensions, especially transverse diameter at C4–6, while age had a lesser effect. Canal: VB ratios decreased with age from C3 to C7, with lower R² values suggesting additional influencing factors.
Clinical Relevance: This is the first study using local paediatric data to assess cervical spine development. Vertebral body dimensions correlated more strongly with age than canal dimensions, with ethnicity having a modest but notable effect—especially on transverse VB diameter. These multifactorial findings have implications for trauma assessment, and the evaluation of SCI risk in adolescents, particularly in high-impact sports.
Keywords: paediatric cervical spine, spinal canal, vertebral body, ethnicity
