Cervical spine anomalies in children and adolescents.

PURPOSE OF REVIEW: Cervical spine anomalies in paediatric patients are difficult to recognize due to the unique anatomy of the developing spine as well as the rarity of their occurrence.

RECENT FINDINGS: Radiographic interpretation is critical to arriving at the correct diagnosis for cervical spine abnormalities. Familiarity with the developmental anatomy and normal variants is critical to prevent the wrong diagnosis.

SUMMARY: Due to the unique anatomy of the cervical spine in paediatric patients, radiographic interpretation can be difficult. The main types of cervical spine anomalies seen in paediatric patients are basilar invagination, C1-C2 instability, atlantoaxial rotatory subluxation, congenital occipitocervical synostosis, congenital unilateral absence of C1, odontoid anomalies and Klippel-Feil syndrome. Unstable anomalies that are symptomatic need surgical intervention to prevent neurologic injuries. For anomalies that are unstable but asymptomatic, consideration for surgical intervention is based on the cause, patient activity level and age.