Variation of odontoid incidence according to age in asymptomatic children.

To investigate the effect of age and sex on odontoid parameters and their relationships with cervical sagittal alignment in children. A total of 155 Chinese children without cervical symptoms were divided into groups by age: 3-12 years (87 participants) and 13-18 years (68 participants) and sex: male (91 participants) and female (64 participants). Lateral plain radiographs of the whole spine were analyzed for (1) odontoid parameters: odontoid incidence (OI), odontoid tilt (OT), and C2 slope (C2S); and (2) cervical sagittal parameters: C0-2, C2-3, C2-4, C2-5, C2-6, and C2-7 angles (cervical lordosis; CL), T1 slope (T1S), and T1S minus CL (T1S-CL). Student's t-tests, linear regression analyses, and Pearson's correlation coefficient analyses were performed. OI showed a significant difference between the 3-12 and 13-18 years groups (13.35° ± 4.32° vs. 17.21° ± 4.26°, p < 0.001), and significant differences were also observed in OT (p = 0.001) and C2S (p < 0.001) between different sexes. Positive correlations were found between age and OI in the 3-12 and 13-18 years groups (adjusted R Age emerged as a critical determinant of OI, which increased with age among pediatric populations. Clinicians should carefully consider the disparity in OI during the assessment and restoration of cervical sagittal balance in children.

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