The paediatric cervical spine has many mechanical differences from that of the adult [7-10]:

  • Relatively large head leading to higher fulcrum of flexion (C2/3)
  • Horizontally aligned facet joints
  • Underdeveloped uncinate process leading to flatter articular surface
  • Anterior ‘wedging’ of vertebral bodies
  • Cartilaginous synchondrosis at the junction of the odontoid peg and C2 vertebral body
  • Less rigid ligamentous support & weak supportive muscles