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Two novel parameters to evaluate the influence of the age and gender on the anatomic relationship of the atlas and axis in children no more than 8 years old: imaging study

  • Spinal Neuroradiology
  • Published:
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Abstract

Purpose

Because of the complex cervical vertebral embryology and some normal variations, the atlantoadental interval (ADI) was not suitable for the evaluation of the anatomic relationship between the atlas and axial in children less than 2 years old. And the influence of the age and gender on the anatomic relationship between atlas and axial in children was still unclear. Two novel parameters, atlas-axis anteroposterior distance (AAAD) and atlas-axis lateral distance (AALD), were invented to evaluate the anatomic relationship between the atlas and axis in the children no more than 8 years old with different age and gender.

Methods

Cross-sectional computed tomography (CT) scans of the atlantoaxial joint for 140 randomly selected pediatric patients no more than 8 years old were analyzed. On the ideal CT reconstruction images, AAAD, AALD, atlantoaxial lateral bending angle (AALB), and atlantoaxial rotation angle (AARA) were measured.

Results

There was no statistically significant difference between the mean AAAD in different age and gender groups. The 99% confidence interval for AAAD was 7.12–7.82 mm. There was no significant correlation between AAAD and AALB/AARA and AALD and AALB/AARA.

Conclusion

The AAAD was less than 7.12 mm or much than 7.82 mm that suggested a possible instability in the atlantoaxial joint and could help the diagnosis of the atlantoaxial instability in children no more than 8 years old. There was no difference between the mean AAAD of pediatric patients no more than 8 years old in different age and gender groups.

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Abbreviations

AAA:

anterior atlas arch

AAAD:

atlas-axis anteroposterior distance

AAI:

atlantoaxial instability

AALB:

atlantoaxial lateral bending angle

AALD:

atlas-axis lateral distance

AARA:

atlantoaxial rotation angle

ADI:

atlantodental interval

CT:

computed tomography

PAA:

posterior atlas arch

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Funding

This study was funded by the Science and Technology Program of Wenzhou China (Grant No. Y20180031), the Zhejiang Provincial Natural Science Foundation of China (Grant No. LY14H060008) and the National Natural Science Foundation of China (Grant No. 81572214).

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Authors and Affiliations

  1. Department of Orthopaedic, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, WenZhou, Zhejiang, China

    Long Wu, Yu Jin, Xiang-Yang Wang, Ai-Min Wu, Sheng Wang, Cheng-Long Xie & Zhong-Ke Lin

  2. The Second School of Medicine, Wenzhou Medical University, WenZhou, Zhejiang, China

    Long Wu, Yu Jin & Cheng-Long Xie

  3. Zhejiang Provincial Key Laboratory of Orthopaedics, WenZhou, Zhejiang, China

    Xiang-Yang Wang, Bi-Dong Fang, Ai-Min Wu, Sheng Wang & Zhong-Ke Lin

  4. Radiology Department, the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, WenZhou, Zhejiang, China

    Bi-Dong Fang

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  1. Long Wu
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Correspondence to Zhong-Ke Lin.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Wu, L., Jin, Y., Wang, XY. et al. Two novel parameters to evaluate the influence of the age and gender on the anatomic relationship of the atlas and axis in children no more than 8 years old: imaging study. Neuroradiology 61, 1407–1414 (2019). https://doi.org/10.1007/s00234-019-02284-z

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