EVOLUTION OF THE INFANT SPINAL COLUMN - EVALUATION WITH MR IMAGING

The appearance of the normal lumbar spinal column was examined in spinal magnetic resonance images obtained in 50 pediatric patients aged 2 years or less. The ossification centers of the developing vertebral bodies, the cartilage, and the disks were studied with a 1.5-T imager by using both short- and long-repetition-time spin-echo sequences. Many of the structures of the spine were noted to undergo dynamic changes in appearance, both in signal intensity and in morphologic characteristics, with growth. The vertebrae and cartilage, especially, transform markedly in infancy and proceed through three characteristic stages of evolution. Stage I, from birth to 1 month of age, is characterized by markedly hypointense ossification centers and hyperintense, prominent cartilage. Stage II, from approximately 1 to 6 months of age, is characterized by increasing signal intensity in the ossification centers, progressing from the end-plates in, and decreasing prominence of the cartilage. Stage III, from approximately 7 months of age on, is characterized by increasingly rectangular and centrally intense vertebral bodies and diminishing cartilage. The variability of the signal intensities, with that of muscle used as the standard, and morphologic characteristics of different components of the spine at different stages of development can create significant confusion. Careful analysis, however, permits one to follow the evolution of the lumbar spine and to date it on the basis of its appearance.