Racial and gender differences of cervical vertebral maturation staging between African Americans versus Caucasian patients of various age groups: A retrospective study

Abstract

The primary purpose of this study was to compare CVM staging between African American (AA) and Caucasian (CC) subjects, grouped based on gender. The secondary objectives were to conduct a CVM comparison of (1) male vs. female subjects, grouped based on their race, and (2) AA vs. CC subjects, categorized based on their age group. All patients between 8-18 years of age (University of XXX), meeting the criteria, were included between the period of the year 2007 to 2020. Three blinded independent evaluators analysed the lateral cephalograms for a 6-stage CVM system (CS1 to CS6) as described by McNamara and Franchi. Samples were divided based on race, gender, and age to conduct the statistical analysis for racial and gender comparisons. Out of the initial 1,300 lateral cephalograms, 1,276 with the mean age: 12.7 years SD 2.5 years, and median CVM: 4 (IQR: 25% percentile- 2 and 75% percentile- 4) were included. Gender-specific racial age comparison showed no significant differences for male subjects for most of the CVM stages (P>0.05). Overall and race-specific gender comparison of age showed significant differences for almost all CVM stages (P<0.05). No significant difference of CVM was found on racial comparison for overall, females (P=0.6131) or males (P=0.0825) subjects. On age-specific racial comparison, AA girls (8-10 years) were skeletally more mature than CC girls (P=0.0143); over 14-year-old CC girls (P<0.0001) and over 16-year-old CC boys (P=0.0008), being skeletally more mature than AA boys of the same age. There was no significant difference between AA and CC subjects on gender-specific comparisons for most of the CVM stages. A significant difference of age was observed for most of the CVM stage between male and female subjects on race-specific comparisons. Female patients were ahead in skeletal maturity as compared to males for each CVM stage. The CVM for 8-12-year-old AA females was significantly higher than that of the CC females, whereas the CVM for>14-year-old CC females was significantly higher than AA females.