Eur Spine J. 2025 Nov 18. doi: 10.1007/s00586-025-09565-7. Online ahead of print.
ABSTRACT
PURPOSE: The aim was to study the developmental characteristics of the cartilaginous union anatomical structure at the base of odontoid process in normal children aged 1 to 6 years, analyze the factors influencing its fusion, and provide basic data for understanding its evolutionary patterns and application in clinical disease diagnosis and treatment. Additionally, the study aimed to conduct morphological staining observations of the anatomical features of the base of the odontoid process in normal children.
METHODS: A total of 140 cases of normal cervical spine CT images from children aged 1 to 6 years were collected and grouped by age, with 20 cases in the 1-year-old group and 30 cases in each of the other four groups. The original data of the cervical spine continuous CT scan images were imported into Mimics 21.0 software in DICOM format for the measurement of anatomical indexes including Transverse Diameter (TD), Sagittal Diameter (SD), Area (A), Perimeter (P), and the positional indexes including Distance from Upper Cartilage Border to Odontoid Process Base (DSB), Distance from Lower Cartilage Border to Odontoid Process Base (DIB), Distance from Left Cartilage Border to Left Transverse Process (DLT), Distance from Right Cartilage Border to Right Transverse Process (DRT). Additionally, the axis vertebra of a 3-year-old child’s cervical spine was extracted, and thin sections were prepared by hard tissue embedding and section techniques. Toluidine blue staining was performed to observe the histopathological characteristics of the cartilaginous intervertebral disc and bone tissue in the base region of the odontoid process.
RESULTS: TD, SD, A, and P values decreased gradually with increasing age. TD, A, and P values showed statistical differences between group E and the other groups (P < 0.05); SD values showed statistical differences between group E and groups A, B, and C (P < 0.05). DSB, DIB, DLT, and DRT values all increased with age. DLT values in groups A and B showed statistical differences with group E (P < 0.05); DRT values in group A showed statistical differences with groups D and E (P < 0.05). There was a high correlation between TD and SD, A and P, DLT and DRT, and a low correlation between TD and DSB, P and DLT, DRT. After staining, it was observed that the chondrocytes in the central region of the base of the odontoid process were scattered and spindle-shaped, while in the peripheral areas, chondrocytes formed oval-shaped clusters, with the cell nuclei stained blue and the matrix showing a light blue color, providing clear contrast with the intervertebral disc and bone tissue.
CONCLUSION: The ossification center of the base of odontoid process in children is in a continuous growth and change process and exhibits evident regularity. The measurement results of this study can provide anatomical data for the growth and developmental characteristics of this region. The cartilage at the base of the odontoid process in children is hyaline cartilage, with the characteristic of being relatively brittle and prone to fracture.
PMID:41249664 | DOI:10.1007/s00586-025-09565-7
