Dimensional changes of cervical and lumbar bony spinal canals in one generation in Western Switzerland: a computed tomography study

Abstract

Younger generation patients have smaller bony spinal canals also in the cervical spine even though this difference is less marked than at the lumbar level. There is, nevertheless, moderate positive correlation between these two anatomical regions. Perinatal factors that adversely influence spinal growth, such as increased maternal age and smoking, could explain these generational changes, given that body height has increased during the same time period. The lesser difference observed in the cervical spine could be due to later closure of the neurocentral synchondrosis at this level.

Developmental cervical spinal canal size: population reference range

“…In line with previous studies, all spinal canal and vertebral dimensions were slightly larger in male than females ( 11 , 15 ). Taller persons had a slightly larger developmental spinal canal CSA, mainly due to an increase in spinal canal width rather than AP sagittal diameter.…”

“…Spinal canal and vertebral body measurements were obtained on data reconstructed in a true axial plane for each vertebra from C3 to C7 (2,610 levels assessed) using ITK-SNAP 3.6.0. The C1 and C2 vertebrae were not included as degenerative spinal canal stenosis is rare in the upper cervical region and these two vertebrae are different morphologically and functionally from the remainder of the cervical spine ( 11 , 15 ). Following optimal image zooming and contrast adjustment, the spinal canal cross-sectional area (CSA), anteroposterior (AP) sagittal diameter, and width as well as the vertebral body CSA, AP sagittal diameter and width were measured at each level manually by one of two operators.…”

Evolution of the Cross-Sectional Area of the Osseous Lumbar Spinal Canal across Decades: A CT Study with Reference Ranges in a Swiss Population

“…Similar to the results published by Schizas et al, Monier et al and Tobin et al, we also demonstrated a decrease in size of the lumbar bone CSA in the younger generations [10][11][12]15]. Griffith al., who analyzed a population of Chinese ethnicity, did not show any change in lumbar bone CSA between the different decades [12].…”

“…Our study confirms the previously reported findings of smaller osseous lumbar spinal canals among younger patients and possibly eliminates any bias as it includes a larger sample size measured longitudinally [11]. When analyzing subgroups by sex and ethnicity, the CSA measured at L4 was larger than the CSA measured at L2 in most of the subgroups and this suggests that the CSA at the L4 level is greater than at the L2 level regardless of sex and ethnicity, as previously reported [10,12,15]. The decrease in CSA in subjects born in later-born cohorts compared to those subjects born a few decades earlier in the last century was found at both levels analyzed.…”

“…An attending musculoskeletal radiologist initially trained three independent observers (two orthopedic residents and a radiologist resident with two years and one year of experience in musculoskeletal imaging, respectively) by reading, in consensus, a sample set of ten cases not included in this study to define lumbar bone CSA and calibrate measurements. The three observers then independently measured the CSA of the osseous spinal canal by drawing the regions of interest (ROIs) at the L2 and L4 pedicle levels (Figure 1) [11,15]. These two vertebral levels were selected to provide a general overview of the lumbar spine while limiting the data collection efforts of the adjacent spinal levels.…”