Normal fetal development of the cervical, thoracic, and lumbar spine: A postmortem study based on magnetic resonance imaging.

Abstract

Before evaluating spinal pathology, it is essential to have knowledge of the normal spinal development at different gestational ages. This study aims to characterize normal spinal growth in human fetuses during the second and third trimesters. Postmortem 3.0T magnetic resonance imaging (MRI) was performed on 55 fetuses at 17-42 gestational weeks by using three-dimensional T2-weighted sequences. Morphological changes and quantitative measurements of the fetal spine were assessed. The correlation between centrum ossification center volume (COCV) and gestational age was investigated. The cervical, thoracic, and lumbar COCVs showed a positive relationship with gestational age (p<0.05). No gender differences were found in the volumetric development of the cervical, thoracic, and lumbar centrum ossification centers (COCs). The average volumetric growth rate per COC was larger in the lumbar spine than in the cervical and thoracic spine. The L1-L5 COCVs also showed a linear positive relationship with gestational age. Postmortem 3.0T MRI clearly demonstrated spinal changes in external contour and internal structure with gestational age. These findings expand our understanding of the early growth pattern of the human spine and could be further used to assess the developmental conditions of the fetal spine.