CT Imaging Analysis of the C7 Pedicle and Lateral Mass in Children Aged 0 to 14 Years

Background and objective: There is currently a lack of anatomical research on the C7 pedicle and lateral mass in children aged 0 to 14 years, and experience with pediatric lower cervical spine surgeries remains limited. This study aims to investigate the anatomical structure of the C7 pedicle and lateral mass in a large pediatric sample to understand their growth patterns, providing imaging and anatomical references for pediatric lower cervical spine surgeries and the design of pediatric C7 screws.

Methods: We measured 12 parameters, including the width, length, height, and angles of the C7 pedicle and lateral mass in children aged 0 to 14 years. The t-test was used to analyze bilateral and gender differences, and least squares regression was applied for curve fitting analysis.

Results: The size parameters of the C7 pedicle and lateral mass generally increased with age, while angular parameters fluctuated within specific ranges. The average values for each parameter between ages 0-14 were as follows: D1: 2.78-5.28mm, D2: 18.15-30.54mm, D3: 2.44-6.01mm, angle A: 38.05-44.48°; D4: 6.81-10.94mm, D5: 5.37-11.23mm, D6: 8.07-13.28mm, D7: 1.94-4.88mm, D8: 5.67-9.39mm, angle C: 18.50-28.80°, angle D: 43.23-52.01°, angle E: 33.74-44.96°. Bilateral analysis showed no significant differences for most parameters across most age groups, with differences mainly observed in angle A, angle C, D6, and D8. Gender differences were primarily noted in length parameters across different age groups, especially in the 3-4, 6-7, 9-11, and 13-14 age groups. Regression analysis indicated that most parameters followed cubic function curves, while a few followed power or quadratic function curves.

Conclusion: This study provides detailed CT imaging anatomy of the C7 pedicle and lateral mass in children aged 0 to 14 years. Preoperative thin-slice CT scans and careful measurements of key parameters are essential for pediatric lower cervical spine surgeries. The findings offer valuable imaging and anatomical references for pediatric posterior cervical fixation surgery and screw design.