203 Evaluation of Lateral Atlantodental Interval Asymmetry in the Pediatric Age Group: Normative Values. Issue Volume 65:Issue CN(2018)Supplement 1 (16th August 2018)

• Record Type: Journal Article
• Authors: Mendenhall, Stephen K; Huh, Andrew; Alentado, Vincent J; Balsara, Karl E; MD, Andrew H. Jea
• Is Part Of: Neurosurgery. Volume 65:Issue CN(2018)Supplement 1
• Page Start: 116
• Page End: 116
• Publication Date: 2018-08-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyy303.203
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: The revelation of normative radiographic measurements for the developing pediatric spine is incomplete. The purpose of this analysis is to determine the normal range of asymmetry of the lateral atlantodental interval (LADI), and define age- and gender-related differences. METHODS: A total of 3072 children age 0 to 18 yr who underwent computed tomography (CT) of the cervical spine were identified at Riley Hospital for Children between 2005 and 2017. Patients were stratified by gender and age (in years) into 36 cohorts. Following this stratification, patients within each group were randomly selected for inclusion until 15 patients in each group had been measured (quota sampling). A total of 540 patients were included for study. Right and left linear measurements were performed on the CT axial plane at the C1 mid-lateral mass level. RESULTS: The overall mean difference between the right and left LADI was 0.09 ± 1.23 mm (range: –6.05 to 4.87 mm). The magnitude of this asymmetry remained statistically insignificant across age groups ( P = .278) and gender ( P = .889). The intraclass correlation coefficient was 0.805, 95% CI [0.779, 0.829]. CONCLUSION: Asymmetry of the LADI is not unusual in asymptomatic children. There is no appreciable difference in magnitude of this asymmetry across age ranges and gender. Measurement of LADI asymmetry shows "good" reliability and is easy to perform. Pediatric neurosurgeons, emergency room physicians, and radiologists should be aware of normative values of asymmetry when interpreting CT scans of the cervical spine. This may prevent unnecessary further workup with dynamic CT or MRI.