Highlights
- •Vertebral bodies (VBs) and annular epiphysis (AE) ratios in the mid-lower C-spine were ≥ throughout the entire C-spine.
- •No significant difference in the mid sagittal length of the anterior and posterior.
- •Males manifest larger VB and AE than females.
- •With age, VBs and AE become larger.
- •These data can be helpful to physicians and surgeon in their treatment plan.
Abstract
BACKGROUND CONTEXT
The annular epiphysis (AE) is a peripheral ring of cortical bone that forms a secondary
ossification center in the superior and inferior surfaces of vertebral bodies (VBs).
The AE is the last ossification site in the skeleton, typically forming at about the
25th year of life. The AE functions jointly with vertebral endplates to anchor the
intervertebral discs to the VBs.
PURPOSE
To establish accurate data on the sizes of the AE of the cervical spine (C3–C7); to
compare the ratios between areas and the ratios of the AE to VBs; to compare the ratios
between the superior and inferior VB surface areas; and to compare AE lengths between
the posterior and anterior midsagittal areas.
STUDY DESIGN
Measurement of 424 cervical spines (C3–C7) obtained from the skeletal collection of
the Natural History Museum, Cleveland, Ohio (USA).
METHODS
The sample was characterized by sex, age, and ethnic origin. The following measurements
were recorded for each vertebra: (1) the surface area of the VBs and the AE, (2) the
midsagittal anterior and posterior length of the AE, (3) the ratios between the AE
and VB surface areas, and (4) the ratios between the superior and inferior disc surface
areas.
RESULTS
The study revealed that the AE and VBs in men were larger than in women. With age,
the AE and VBs became larger; the ratio between the AE and VB surface was approximately
0.5 throughout the middle to lower cervical spine. The ratio of superior to inferior
VBs was approximately 0.8. We found no differences between African Americans versus
European Americans or between the anterior versus the posterior midsagittal length
of the AE of the superior and inferior VBs.
CONCLUSIONS
The ratios between the superior and inferior VBs are ≥0.8, and the ratio is the same
for the entire middle to lower spine. Thus, the ratio between the superior and inferior
VBs to the AE is ≥ 0.5. Men had larger AEs and VBs than women did, with both VBs and
AEs becoming larger with age. Knowing these relationships are important so that orthopedic
surgeons can best correct these issues in young patients (<25 years old) during spine
surgery. The data reported here provide, for the first time, all the relevant sizes
of the AE and VB. In future studies, AEs and VBs of living patients can be measured
with computed tomography.
CLINICAL SIGNIFICANCE
The ER location and function are clinically significant showing any changes during
life that might lead to clinical issues related to intervertebral discs such as intervertebral
disc asymmetry, disc herniation, nerve pressure, cervical osteophytes and neck pain.
Keywords
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Article info
Publication history
Published online: May 02, 2023
Accepted:
April 11,
2023
Received in revised form:
March 29,
2023
Received:
June 10,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
FDA device/drug status: Not applicable.
Author disclosures: DE: Nothing to disclose. AB: Nothing to disclose. SL: Nothing to disclose. IV: Nothing to disclose. MN: Nothing to disclose. GD: Nothing to disclose.
Identification
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