Geometric growth of the normal human craniocervical junction from 0 to 18 years old

Abstract

The craniocervical junction (CCJ) forms the bridge between the skull and the spine, a highly mobile group of joints that allows the mobility of the head in every direction. The CCJ plays a major role in protecting the inferior brainstem (bulb) and spinal cord, therefore also requiring some stability. Children are subjected to multiple constitutive or acquired diseases involving the CCJ: primary bone diseases such as in FGFR‐related craniosynostoses or acquired conditions such as congenital torticollis, cervical spine luxation, and neurological disorders. To design efficient treatment plans, it is crucial to understand the relationship between abnormalities of the craniofacial region and abnormalities of the CCJ. This can be approached by the study of control and abnormal growth patterns. Here we report a model of normal skull base growth by compiling a collection of geometric models in control children. Focused analyses highlighted specific developmental patterns for each CCJ bone, emphasizing rapid growth during infancy, followed by varying rates of growth and maturation during childhood and adolescence until reaching stability by 18 years of age. The focus was on the closure patterns of synchondroses and sutures in the occipital bone, revealing distinct closure trajectories for the anterior intra‐occipital synchondroses and the occipitomastoid suture. The findings, although based on a limited dataset, showcased specific age‐related changes in width and closure percentages, providing valuable insights into growth dynamics within the first 2 years of life. Integration analyses revealed intricate relationships between skull and neck structures, emphasizing coordinated growth at different stages. Specific bone covariation patterns, as found between the first and second cervical vertebrae (C1 and C2), indicated synchronized morphological changes. Our results provide initial data for designing inclusive CCJ geometric models to predict normal and abnormal growth dynamics.

Anatomy and mobility in the adult cadaveric craniocervical junction

“…This may enable us to test the effect of muscle action, the mechanical properties of the soft tissues, and to test the relative importance of variation in the anatomy of the facets (and the degree of symmetry which may vary between individuals) as potential driver of mobility of the secondary movements. Finally, this type of simulation would also enable the estimation of the influence of the overall bone geometry (more specifically through growth, see Raoul-Duval et al, 2024) on primary motion through variation in insertion sites for tendons and ligaments, and therefore lever arms.…”

“…In the case we found that kinematics can be inferred from morphological features, decision making and surgical planning would be greatly facilitated as the aimed functional outcome (mobility and stability) could be translated into a clear objective of morphological outcome. This is especially true since a recent study has paved the way for this investigation by providing a thorough quantitative description of the geometric growth of the CCJ from postnatal stage to 18 years old (Raoul-Duval et al, 2024).…”