2011
DOI: 10.3171/2011.6.peds11187
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Developmental anatomy of the atlas and axis in childhood by computed tomography

Abstract: Object The CT modality plays a central role in the diagnosis of cervical spine fractures. In childhood, radiolucent synchondroses between ossification centers can resemble fractures, and they can be the sites of fractures as well. Recognition of cervical spine fractures in children requires familiarity with normal developmental anatomy and common variants as they appear on CT scans. Methods A convenience… Show more

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Cited by 65 publications
(73 citation statements)
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“…Knowledge of normal pre-and postnatal cervical spine maturation has been derived mainly from autopsy specimens and plain film imaging [2][3][4][5][6] and only rarely by CT. 7,8 The limited ability of children to cooperate in obtaining satisfactory roentgenograms has established CT as the technique of choice to study acute CVJ injuries. 9 The presence of large unossified cartilaginous parts of the atlas and axis, numerous and sometimes unexpected synchondroses, and osseous gaps at a laterthan-expected age, are potential pitfalls.…”
mentioning
confidence: 99%
See 1 more Smart Citation
“…Knowledge of normal pre-and postnatal cervical spine maturation has been derived mainly from autopsy specimens and plain film imaging [2][3][4][5][6] and only rarely by CT. 7,8 The limited ability of children to cooperate in obtaining satisfactory roentgenograms has established CT as the technique of choice to study acute CVJ injuries. 9 The presence of large unossified cartilaginous parts of the atlas and axis, numerous and sometimes unexpected synchondroses, and osseous gaps at a laterthan-expected age, are potential pitfalls.…”
mentioning
confidence: 99%
“…Recent work has attempted to estimate the ossification rate of normal synchondroses at the CVJ. 8 Nevertheless, variations within the anterior part of the atlas and at the apical portion of the dens need further analysis. Therefore, the aim of our study was to more extensively determine the normal milestones in the osseous development of CVJ in CT images of children and adolescents, paying special attention to time-related closure of synchondroses and osseous bridges, and to identify normal variants, based on a large population.…”
mentioning
confidence: 99%
“…Midline fusion defects of the C1 arch occurred in 29% of our patients but occur much less frequently (2% to 4%) in the general population [14][15][16] . In addition, our patients had anterior arch defects more often than posterior arch defects; in the general population, posterior arch defects are typically 4.5 times more common 16,17 .…”
Section: Discussionmentioning
confidence: 62%
“…The dentate ossification center forms the neck and base of the dens while the tip of the odontoid process is formed by the apical center. 5,18 The ossification centers are separated by cartilaginous synchondroses; the neurocentral synchondroses are among the neural arches and C-2 body, and the dentocentral synchondrosis is between the dentate center and C-2 body. The synchondroses fuse at 3-6 years of age.…”
Section: Discussionmentioning
confidence: 99%
“…We agree with the assumption of Tubbs et al 21 that other measurement techniques relied either on a relatively variable anatomical structure such as the base of the C-2 vertebral body or a difficult to identify landmark such as the midbody of the C-2 vertebra. Tubbs et al 21 introduced the odontoid retroflexion angle based on the dentocentral synchondrosis of C-2, a readily identifiable and extremely consistent finding on both CT 18 and MRI scans 2 that serves as an embryological landmark of the inferior boundary of the odontoid process base.…”
Section: Discussionmentioning
confidence: 99%