Changes in craniovertebral junction morphometry according to age and gender: A retrospective study

Craniovertebral junction (CVJ) is a functional unit that serves as a transition zone from the skull to the spine and contains many important neural and vascular structures. Age is one of the factors that complicates diagnosis and treatment. Especially in the pediatric group, the presence of smaller bone and connective tissue structures, insufficient bone development and the presence of syndondrosis make it difficult to diagnose and treat correctly. The aim of our study is to determine the normal values of some angular and linear parameters that are important in the clinical evaluation of KVB in pediatric and adult age groups. Computed tomography images of healthy 420 individuals aged 4-25 years (M:257, F:163) were evaluated retrospectively. Considering the bone development of the pediatric group, these subdivided into 7 different age groups. A total of 20 parameters, including 14 midsagittal, 1 parasagittal, 1 coronal, 3 in the axial section, and 1 using the formula, which are critical in the evaluation of the region, were examined. We found that the height of the right and left condylus occipitalis, the length of the McRae line, the distance of the apex dentis to the McRae line, the Chamberlain line, the basion-axial interval and the foramen magnum area showed statistically significant differences between the 4-6 age groups and all other age groups. We found that the width of the right and left condylus occipitalis and the basion-dental interval differed statistically significantly between the 4-6 age groups and all other age groups except the 7-9 age group. The posterior atlantodental interval show statistically significant differences between the sexes in the other 5 age groups except for the 4-6 and 19-21 age groups. We think that our study, in which we evaluated many clinically important critical parameters related to the region with a holistic approach and planned by creating detailed age groups, will be a guide for clinicians working in this field.