The Pediatric Spine

Giovanna Stefania Colafati; Antonio Marrazzo; Marco Cirillo; Paola d'Angelo; Domenico Barbuti; Laura Tanturri de Horatio; Paolo Tomà; Alessandra Bartoloni

doi:10.1055/s-0041-1727095

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2021; 25(01): 137-154
DOI: 10.1055/s-0041-1727095

Review Article

The Pediatric Spine

Authors

Giovanna Stefania Colafati

¹Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
Antonio Marrazzo

¹Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
Marco Cirillo

¹Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
Paola d'Angelo

¹Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
Domenico Barbuti

¹Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
Laura Tanturri de Horatio

¹Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
Paolo Tomà

¹Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
Alessandra Bartoloni

¹Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy

Abstract

The spine, a frequently investigated site in children, has a complex development in relation to both nervous and bone/cartilaginous structures and shows several particular features in children compared with adults. We report the main normal variants and pathologies of the pediatric spine, from the prenatal period to adolescence, focusing on a multimodality imaging approach.

Keywords

spine - pediatric - magnetic resonance imaging - ultrasound - computed tomography

Full Text

References

References
1 Byrd SE, Darling CF, McLone DG. Developmental disorders of the pediatric spine. Radiol Clin North Am 1991; 29 (04) 711-752
2 De Biasio P, Ginocchio G, Aicardi G, Ravera G, Venturini PL, Vignolo M. Ossification timing of sacral vertebrae by ultrasound in the mid-second trimester of pregnancy. Prenat Diagn 2003; 23 (13) 1056-1059
3 Zalel Y, Lehavi O, Aizenstein O, Achiron R. Development of the fetal spinal cord: time of ascendance of the normal conus medullaris as detected by sonography. J Ultrasound Med 2006; 25 (11) 1397-1401 ; quiz 1402–1403
4 Simon EM. MRI of the fetal spine. Pediatr Radiol 2004; 34 (09) 712-719
5 Hill CA, Gibson PJ. Ultrasound determination of the normal location of the conus medullaris in neonates. AJNR Am J Neuroradiol 1995; 16 (03) 469-472
6 Yundt KD, Park TS, Kaufman BA. Normal diameter of filum terminale in children: in vivo measurement. Pediatr Neurosurg 1997; 27 (05) 257-259
7 Tomà P. Spine and spinal cord sonography. In: Tortori-Donati P, Rossi A. eds. Pediatric Neuroradiology. Berlin, Germany: Springer; 2005: 1715-1723
8 Tomà P, Bartoloni A, Salerno S. et al. Protecting sensitive patient groups from imaging using ionizing radiation: effects during pregnancy, in fetal life and childhood. Radiol Med (Torino) 2019; 124 (08) 736-744
9 Rossi A, Martinetti C, Morana G, Severino M, Tortora D. Diagnostic approach to pediatric spine disorders. Magn Reson Imaging Clin N Am 2016; 24 (03) 621-644
10 Palasis S, Hayes LL. Acquired pathology of the pediatric spine and spinal cord. Pediatr Radiol 2015; 45 (Suppl. 03) S420-S432
11 Rossi A, Gandolfo C, Morana G, Tortori-Donati P. Tumors of the spine in children. Neuroimaging Clin N Am 2007; 17 (01) 17-35
12 Meyer JS, Jaramillo D. Musculoskeletal MR imaging at 3 T. Magn Reson Imaging Clin N Am 2008; 16 (03) 533-545 , vi
13 Colafati GS, Rossi E, Carducci C. et al. Half-dose versus full-dose macrocyclic gadolinium at 3-T magnetic resonance imaging in paediatric bone and soft-tissue disease. Pediatr Radiol 2018; 48 (12) 1724-1735
14 Byrd SE, Comiskey EM. Postnatal maturation and radiology of the growing spine. Neurosurg Clin N Am 2007; 18 (03) 431-461
15 Brill PW, Baker DH, Ewing ML. “Bone-within-bone” in the neonatal spine. Radiology 1973; 108: 363-366
16 Tortori-Donati P, Rossi A, Cama A. Spinal dysraphism: a review of neuroradiological features with embryological correlations and proposal for a new classification. Neuroradiology 2000; 42 (07) 471-491
17 Rossi A, Biancheri R, Cama A, Piatelli G, Ravegnani M, Tortori-Donati P. Imaging in spine and spinal cord malformations. Eur J Radiol 2004; 50 (02) 177-200
18 Schwartz ES, Rossi A. Congenital spine anomalies: the closed spinal dysraphisms. Pediatr Radiol 2015; 45 (Suppl. 03) S413-S419
19 Ascent of the conus medullaris. In: The ISPN Guide to Pediatric Neurosurgery. Accessed February 10, 2016 at: http://ispn.guide/book/ispn-guide-pediatric-neurosurgery
20 Pang D, Zovickian J, Oviedo A, Moes GS. Limited dorsal myeloschisis: a distinctive clinicopathological entity. Neurosurgery 2010; 67 (06) 1555-1579 ; discussion 1579–1580
21 Dias MS. Normal and abnormal development of the spine. Neurosurg Clin N Am 2007; 18 (03) 415-429
22 Chaturvedi A, Klionsky NB, Nadarajah U, Chaturvedi A, Meyers SP. Malformed vertebrae: a clinical and imaging review. Insights Imaging 2018; 9 (03) 343-355
23 Oskouian Jr RJ, Sansur CA, Shaffrey CI. Congenital abnormalities of the thoracic and lumbar spine. Neurosurg Clin N Am 2007; 18 (03) 479-498
24 Buonuomo PS, Macchiaiolo M, Colafati GS. et al. Persistent neck pain in a girl: Klippel-Feil syndrome. Arch Dis Child 2014; 99 (03) 290-291
25 Rossi A. Pediatric spinal infection and inflammation. Neuroimaging Clin N Am 2015; 25 (02) 173-191
26 Stettler S, El-Koussy M, Ritter B. et al. Non-traumatic spinal cord ischaemia in childhood—clinical manifestation, neuroimaging and outcome. Eur J Paediatr Neurol 2013; 17 (02) 176-184
27 Ahluwalia R, Hayes L, Chandra T, Maugans TA. Pediatric fibrocartilaginous embolism inducing paralysis. Childs Nerv Syst 2020; 36 (02) 441-446
28 Absoud M, Greenberg BM, Lim M, Lotze T, Thomas T, Deiva K. Pediatric transverse myelitis. Neurology 2016; 87 (09) (Suppl. 02) S46-S52
29 Messacar K, Schreiner TL, Maloney JA. et al. A cluster of acute flaccid paralysis and cranial nerve dysfunction temporally associated with an outbreak of enterovirus D68 in children in Colorado, USA. Lancet 2015; 385 (9978): 1662-1671
30 Early SD, Kay RM, Tolo VT. Childhood diskitis. J Am Acad Orthop Surg 2003; 11 (06) 413-420
31 Eismont FJ, Bohlman HH, Soni PL, Goldberg VM, Freehafer AA. Vertebral osteomyelitis in infants. J Bone Joint Surg Br 1982; 64 (01) 32-35
32 Garron E, Viehweger E, Launay F, Guillaume JM, Jouve JL, Bollini G. Nontuberculous spondylodiscitis in children. J Pediatr Orthop 2002; 22 (03) 321-328
33 Tsirikos AI, Tome-Bermejo F. Spondylodiscitis in infancy: a potentially fatal condition that can lead to major spinal complications. J Bone Joint Surg Br 2012; 94 (10) 1399-1402
34 Tyagi R. Spinal infections in children: A review. J Orthop 2016; 13 (04) 254-258
35 Tortori-Donati P, Rossi A, Biancheri R. et al. Tumors of the spine and spinal cord. In: Tortori-Donati P, Rossi A. eds. Pediatric Neuroradiology. Berlin, Germany: Springer; 2005: 1609-1651
36 Ansari S, Amanullah MF, Ahmad K, Rauniyar RK. Pott's spine: diagnostic imaging modalities and technology advancements. N Am J Med Sci 2013; 5 (07) 404-411
37 Huisman TA. Pediatric tumors of the spine. Cancer Imaging 2009; 9 Spec No A: S45-S48
38 Koeller KK, Rosenblum RS, Morrison AL. Neoplasms of the spinal cord and filum terminale: radiologic-pathologic correlation. Radiographics 2000; 20 (06) 1721-1749
39 Smith AB, Soderlund KA, Rushing EJ, Smirniotopolous JG. Radiologic-pathologic correlation of pediatric and adolescent spinal neoplasms: Part 1, Intramedullary spinal neoplasms. AJR Am J Roentgenol 2012; 198 (01) 34-43
40 Nadkarni TD, Rekate HL. Pediatric intramedullary spinal cord tumors. Critical review of the literature. Childs Nerv Syst 1999; 15 (01) 17-28
41 Soderlund KA, Smith AB, Rushing EJ, Smirniotopolous JG. Radiologic-pathologic correlation of pediatric and adolescent spinal neoplasms: Part 2, Intradural extramedullary spinal neoplasms. AJR Am J Roentgenol 2012; 198 (01) 44-51
42 Pollack IF. Intramedullary spinal cord astrocytomas in children. Pediatr Blood Cancer 2004; 43 (06) 617-618
43 Cacchione A, Mastronuzzi A, Cefalo MG. et al. Pediatric spinal glioblastoma of the conus medullaris: a case report of long survival. Chin J Cancer 2016; 35: 44
44 Louis DN, Perry A, Reifenberger G. et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 2016; 131 (06) 803-820
45 Lakhani DA, Mankad K, Chhabda S. et al. Diffuse leptomeningeal glioneuronal tumor of childhood. AJNR Am J Neuroradiol 2020; 41 (11) 2155-2159
46 Ben Ammar L, Ferjani H, Maatallah K. et al. Spinal cord compression by extramedullary hematopoiesis in beta-thalassemia major. Clin Case Rep 2020; 8 (08) 1433-1436
47 Ravindra VM, Eli IM, Schmidt MH, Brockmeyer DL. Primary osseous tumors of the pediatric spinal column: review of pathology and surgical decision making. Neurosurg Focus 2016; 41 (02) E3
48 Davies M, Cassar-Pullicino VN, Davies AM, McCall IW, Tyrrell PN. The diagnostic accuracy of MR imaging in osteoid osteoma. Skeletal Radiol 2002; 31 (10) 559-569
49 Greenspan A, Remagen W. Differential Diagnosis of Tumors and Tumor-Like Lesions of Bones and Joints. Philadelphia, PA: Lippincott-Raven; 1998: 25-122
50 Garg S, Mehta S, Dormans JP. Modern surgical treatment of primary aneurysmal bone cyst of the spine in children and adolescents. J Pediatr Orthop 2005; 25 (03) 387-392
51 Azouz EM, Saigal G, Rodriguez MM, Podda A. Langerhans' cell histiocytosis: pathology, imaging and treatment of skeletal involvement. Pediatr Radiol 2005; 35 (02) 103-115
52 Currarino G, Coln D, Votteler T. Triad of anorectal, sacral, and presacral anomalies. AJR Am J Roentgenol 1981; 137 (02) 395-398
53 Schurink M, van Herwaarden-Lindeboom MY, Coppes MH, Veldhuizen AG, Koetse HA, de Langen ZJ. Neurenteric cyst—a case report of this rare disorder. J Pediatr Surg 2007; 42 (05) E5-E7
54 Ozaki T, Flege S, Liljenqvist U. et al. Osteosarcoma of the spine: experience of the Cooperative Osteosarcoma Study Group. Cancer 2002; 94 (04) 1069-1077
55 Moulopoulos LA, Dimopoulos MA. Magnetic resonance imaging of the bone marrow in hematologic malignancies. Blood 1997; 90 (06) 2127-2147
56 Menashe SJ, Tse R, Nixon JN. et al. Brachial plexus birth palsy: multimodality imaging of spine and shoulder abnormalities in children. AJR Am J Roentgenol 2015; 204 (02) W199-206
57 Aralasmak A, Karaali K, Cevikol C, Uysal H, Senol U. MR imaging findings in brachial plexopathy with thoracic outlet syndrome. AJNR Am J Neuroradiol 2010; 31 (03) 410-417
58 Huisman TA, Wagner MW, Bosemani T, Tekes A, Poretti A. Pediatric spinal trauma. J Neuroimaging 2015; 25 (03) 337-353
59 Hollingshead MC, Castillo M. Trauma to the spinal column. In: Naidich TP, Castillo M, Cha S. et al, eds. Imaging of the Spine. Philadelphia, PA: Saunders/Elsevier; 2011: 219-236
60 Lustrin ES, Karakas SP, Ortiz AO. et al. Pediatric cervical spine: normal anatomy, variants, and trauma. Radiographics 2003; 23 (03) 539-560
61 Khanna G, El-Khoury GY. Imaging of cervical spine injuries of childhood. Skeletal Radiol 2007; 36 (06) 477-494
62 Spinnato P, Zarantonello P, Guerri S. et al. Atlantoaxial rotatory subluxation/fixation and Grisel's syndrome in children: clinical and radiological prognostic factors. Eur J Pediatr 2021; 180 (02) 441-447
63 Diel J, Ortiz O, Losada RA, Price DB, Hayt MW, Katz DS. The sacrum: pathologic spectrum, multimodality imaging, and subspecialty approach. Radiographics 2001; 21 (01) 83-104
64 Damasio MB, de Horatio LT, Boavida P. et al. Imaging in juvenile idiopathic arthritis (JIA): an update with particular emphasis on MRI. Acta Radiol 2013; 54 (09) 1015-1023
65 Toiviainen-Salo S, Markula-Patjas K, Kerttula L, Soini I, Valta H, Mäkitie O. The thoracic and lumbar spine in severe juvenile idiopathic arthritis: magnetic resonance imaging analysis in 50 children. J Pediatr 2012; 160 (01) 140-146
66 Sheybani EF, Khanna G, White AJ, Demertzis JL. Imaging of juvenile idiopathic arthritis: a multimodality approach. Radiographics 2013; 33 (05) 1253-1273
67 Herregods N, Dehoorne J, Joos R. et al. Diagnostic value of MRI features of sacroiliitis in juvenile spondyloarthritis. Clin Radiol 2015; 70 (12) 1428-1438
68 D'Angelo P, de Horatio LT, Toma P. et al. Chronic nonbacterial osteomyelitis - clinical and magnetic resonance imaging features. Pediatr Radiol 2021; 51 (02) 282-288
69 Lim MR, Yoon SC, Green DW. Symptomatic spondylolysis: diagnosis and treatment. Curr Opin Pediatr 2004; 16 (01) 37-46
70 Garg M, Kumar S, Satija B, Gupta R. Pediatric intervertebral disc calcification: a no touch lesion. J Craniovertebr Junction Spine 2012; 3 (01) 23-25
71 Offiah AC. Skeletal dysplasias: an overview. Endocr Dev 2015; 28: 259-276
72 Panda A, Gamanagatti S, Jana M, Gupta AK. Skeletal dysplasias: a radiographic approach and review of common non-lethal skeletal dysplasias. World J Radiol 2014; 6 (10) 808-825
73 Bonafe L, Cormier-Daire V, Hall C. et al. Nosology and classification of genetic skeletal disorders: 2015 revision. Am J Med Genet A 2015; 167A (12) 2869-2892
74 Lachman RS. Skeletal dysplasias. In: Slovis TL. ed. Caffey's Pediatric Diagnostic Imaging. 11th ed.. Philadelphia, PA: Mosby Elsevier; 2008: 2613-2671

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