Abstract
MRI studies of the upper spines of 121 children were evaluated to precisely define the sagittal anatomy at C1 in the pediatric population. The diameters of the spinal cord, bony canal, space available for the cord (SAC), dens+atlanto-dens interval (ADI), and "free" space were measured. The results demonstrate an accelerated growth in the C1 canal, dens + ADI, and SAC during the first four years after birth. Steel's rule of thirds was shown to roughly hold true throughout childhood. Neonates have an average SAC diameter of 12.4 mm, a value less than the 13 mm dimension commonly used to define relative stenosis in children.
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