Postnatal development and structure of the neurocentral junction. Its relevance for spinal surgery.

STUDY

DESIGN

The early and late development of the neurocentral junction between the vertebral arch and the vertebral body was studied, and this structure was related to spinal surgery.

OBJECTIVES

Because of its strategic position within the vertebral body, its structure could be of relevance for spinal surgery. During the positioning of cannulated pedicle screws and before penetration into the cancellous bone of the vertebral body, resistance had to be overcome inside the "pedicle" of the vertebral arch. Was this point of resistance related to the neurocentral joint?

SUMMARY OF BACKGROUND DATA: Data on the fate of this developmental structure after age 3-6 years, the age at which it fuses, appeared to be missing in literature.

METHODS

We examined dry bone and "fresh" vertebrae from individuals ranging in age from 0 to 75 years. Observations were recorded by means of gross anatomic photographs, micrographs, radiographs, and computed tomography scans.

RESULTS

After fusion of the junction at age 3-6 years, its structure persists through life as a bilateral plate of bone extending from the cranial to the caudal anular epiphyses inside the dorsolateral parts of the definitive body.

CONCLUSIONS

This plate may function as a support for pedicle screw fixation. Its form explains typical burst fractures of the vertebral body. Spondylolysis at this site is unknown.