The Development of the Cervical Vertebrae as an Indicator of Skeletal Maturity: Comparison with the Classic Method of Hand-wrist Radiograph

Abstract

The objective of this study was to compare three methods with which to determine the skeletal maturity of children. The methods were Greulich & Pyle's atlas method based on hand-wrist radiographs (1959), and the cervical vertebrae methods based on lateral cephalograms of Lamparski (1972) and San Roman et al. (2002). We evaluated hand-wrist radiographs and the lateral cephalograms of 392 children (195 girls and 197 boys age 7-18). The morphology of the second (C2), third (C3) and fourth (C4) cervical vertebrae was assessed and the stage of skeletal maturity determined along with chronological age. Our results revealed a significant correlation (p <or= 0.05) between the skeletal maturity of the cervical vertebrae and the skeletal maturity of the hand. The correlation coefficients between the skeletal maturity of the cervical vertebrae and chronological age were obviously lower. The correlation coefficients were higher when using the method of San Roman et al. (2002) rather than Lamparski's method (1972). Our results show that in assessing skeletal maturity, the lateral cephalogram can replace the hand-wrist radiograph, thus reducing the patient's exposure to radiation.