Zeitschrift für Wirbelsäule

The Role of B-mode Ultrasonography in the Anatomical Evaluation of the Cervical Region of the Spine in Adolescents

Abstract

Abdullaev R. Ya, Ibragimova KN, Kalashnikov VI and Abdullaev RR

Objective: Ultrasonographic evaluation of the anatomy of the intervertebral discs, vertebral canal of the cervical spine in practically healthy adolescents.

Materials and methods: The study included 72 healthy children with normal neurologic status, 35 of them aged 13-15 years, 37-16-18 years old. Ultrasonography (USG) was performed at the level of disks C2-C3, C3-C4, C4-C5, C5-C6, C6-C7, C7-Тh1 in longitudinal and transverse projections. In the longitudinal projection, the height of the intervertebral discs (IVD) and vertebral bodies (V), their ratio (IVD/V), and in the transverse projection - the sagittal size of the IVD, the spinal canal (SC), their sagittal size ratio IVD/SC, the width of spinal nerve canals (NC), the yellow ligament thickness, the sagittal size of the anterior dural space (ADS), their ratio of the ADS and SC (ADS/ SC). In addition to the quantitative parameters of the IVD and SC, the echo structure of the nucleus pulpous (NP) and fibrous ring (FR) was also studied.

Results: The highest sagittal size IVD and SC in the age groups 13-15 (15.6 ± 0.8 mm and 16.4 ± 0.9 mm) and 16-18 years (16.9 ± 0.7 mm and 17.3 ± 0.8 mm) was recorded at the level of C2-C3. Only in the age group 16-18 years were no significant differences (p<0.05) compared with the level of C7-Th1 (17.3 ± 0.8 mm in front of 15.2 ± 0.7 mm). In both age groups, the height of the IVD was also the highest at C2-C3 (4.2 ± 0.23 mm and 4.5 ± 0.37 mm), but no significant differences compared with the levels of C2-C3 and C7-Th1 has not been revealed.

SC area was calculated from the linear dimensions and on the perimeter. At the level of C2-C3 in 13-15 years, these figures were 188 ± 11 mm2 and 287 ± 14 mm2, aged 16-18 years - and 195 ± 12 mm2 312 ± 14 mm2. At the level of C7-Th1 these figures were 152 ± 8 mm2 (p<0.05), 158 ± 7 mm2 (p<0.01), 236 ± 12 mm2 (p<0.001), 248 ± 9 mm2 (p<0.001).

The thickness of the yellow ligament (YL (TAR-reject) increases from top to bottom, it was the highest level of C6- C7 in the age group 16-18 years and was 2.8 ± 0.24 mm significantly (p<0.05) higher than at the level of C2 C3 (2.1 ± 0.15 mm).

Sagittal size anterior dural space (ADS) in all children at all levels of IVD profit lower than the rear PDS index ADS/PDS was lowest at C4-C5 and was 0.82 ± 0.03.

Conclusion: In adolescents, the sagittal size of the intervertebral disc and spinal canal, the height of the IVD, the frontal size, the area of the SC, the width of the spinal nerve canals, the dural spaces have the largest value at the C2-C3 level, the smallest at the C6-C7 and C7-Th1 levels. The smallest ratio of IVD/SC is observed at the level of C2- C3. The maximum thickness of the yellow ligament is recorded at the level of C6-C7, the smallest sagittal dimension of the anterior dural space is determined at the level of C6-C7 and C7-Th1.