A Three-Dimensional Computed Tomographic Analysis of the Cervical Spine in Unoperated Infants with Cleft Lip and Palate

Abstract

Objective: To investigate anatomical variations and abnormalities of cervical spine morphology in unoperated infants with cleft lip and palate. Design: Retrospective cross-sectional investigation of infants born with nonsyndromic cleft lip and palate using computed tomography scans acquired for investigation of a spectrum of clinical conditions. Setting: Computed tomography scan data were obtained from 29 unoperated cleft lip and palate infants and 12 noncleft infants of Malay origin, ages 0 to 12 months. Methods: Observational study of cervical spine computed tomography scans. Heights of cervical vertebral bodies (C2-C7) and intervertebral spaces were measured from landmarks identified from computed tomography reformats and three-dimensional computed tomography reconstructions. Linear modeling of heights and spaces, with age as a covariate, was undertaken to identify differences between the samples. Results: Anomalous features observed in the cleft lip and palate sample included short posterior arch of C1 (2/29), abnormal development of the anterior arch of C1 (2/29), and fusions of the posterior arch of C2 and C3 (2/29). No anomalies of the cervical spine were observed in the noncleft sample. Although the heights of three cervical vertebral bodies were significantly smaller and two intervertebral spaces were significantly larger in infants with cleft lip and palate compared with noncleft infants (p < .05), overall length of the cervical spine did not differ significantly between the samples. Conclusion: There was evidence for subtle upper spinal anomalies in the infant cleft lip and palate population. Our finding of reduced size of some cervical vertebral bodies may reflect delayed upper spinal development in infants with cleft lip and palate.