MRI-based Morphometric Assessment of the Pediatric Cervical Spinal Cord and Spinal Canal

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Cansiz M. S., ÖZTÜRK M., Bayramoglu Z., DAĞ N.

JOURNAL OF ACADEMIC RESEARCH IN MEDICINE-JAREM, cilt.16, sa.2, ss.98-105, 2026 (ESCI, TRDizin)

Özet

Objective: To establish magnetic resonance imaging (MRI)-based reference morphometrics of the pediatric cervical spinal cord and spinal canal in children and adolescents with normal cervical MRI findings, and to assess age-, sex-, and level-related variation. Methods: Cervical spine MRI examinations from 300 children and adolescents, including 150 girls and 150 boys aged 3-17 years, were retrospectively analyzed. All subjects had normal cervical spinal cord and spinal canal morphology on imaging. Participants were equally distributed by sex within three age groups: 3-6 years, Group 1; 7-12 years, Group 2; and 13-17 years, Group 3. T2-weighted sagittal and axial images were obtained using a 1.5-T MRI system. At the mid-vertebral levels of C2, C4, and C6, anteroposterior diameters and cross-sectional areas of the spinal cord and spinal canal were measured using standardized protocols. Appropriate parametric or non-parametric tests were used; p<0.05 was considered significant. Results: Across C2, C4, and C6, boys had significantly larger anteroposterior diameters and cross-sectional areas of the spinal cord and canal than girls (all p<0.05). The spinal cord cross-sectional area showed the most consistent age-related increase. At C4, mean cord area increased from 52.3 +/- 4.1 mm2 in Group 1 to 58.7 +/- 4.6 mm2 in Group 2 and 63.4 +/- 5.2 mm2 in Group 3. At C2, cord anteroposterior diameter increased progressively with age, 6.8 +/- 0.5, 7.3 +/- 0.6, and 7.9 +/- 0.7 mm for Groups 1-3, respectively; p<0.001. At C6, canal anteroposterior diameter and canal area increased with age, whereas the cord anteroposterior diameter did not change significantly. Conclusion: Pediatric cervical cord and canal dimensions vary by sex, age, and vertebral level in children and adolescents with normal cervical MRI findings. Cross-sectional area measurements may complement anteroposterior diameters. These MRI-based reference values may support pediatric cervical MRI interpretation and developmentally informed surgical planning.