Imaging characteristics of lumbar vertebral ring apophysis development in the Chinese population

doi:10.13418/j.issn.1001-165x.2025.6.05

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Chinese Journal of Clinical Anatomy ›› 2025, Vol. 43 ›› Issue (6) : 653-659. DOI: 10.13418/j.issn.1001-165x.2025.6.05

Imaging characteristics of lumbar vertebral ring apophysis development in the Chinese population

Xie Siyuan¹, Li Yikai¹,², Lu Xiongguang³, Cao Junjie¹, Liu Dan⁴*

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Abstract

Objective To characterize the imaging features of lumbar vertebral epiphyseal ring development in the Chinese population, analyze ossification and fusion patterns in different age groups and genders, and provide evidence for the diagnosis and prevention of adolescent spinal disorders. Methods A retrospective analysis was conducted on lumbar CT scans of 507 healthy individuals (252 males, 255 females) aged 6 to 30 years from Nanfang hospital between January 2013 and December 2023. Based on imaging grading criteria, two independent observers assessed lumbar epiphyseal ring maturity (S0-S4). Spearman's rank correlation and intergroup comparisons were used to analyze developmental variations by age, gender, and anatomical regions. Results Inter- and intra-observer consistency was excellent. Median epiphyseal ring maturity significantly correlated with age (r=0.97, P<0.001). Ossification primarily occurred between 7 and 14 years, with maturation initiating after 14 years. Median maturity reached S4 (complete maturation) at 18 years, yet 38% of epiphyseal rings remained unfused. Females exhibited earlier developmental stages than males. Ossification and fusion predominantly began in posterior regions, with anterior regions completing later. Conclusions Lumbar ring apophysis development in the Chinese population demonstrates distinct age-, gender-, and region-specific variations. The contradiction between immature apophyses and abrupt spinal loading during peak height velocity (PHV) in females may elevate spinal deformity risks. This study provides imaging evidence for preventing and managing adolescent spinal developmental abnormalities and injuries.

Key words

Adolescent / / / Development / / / Lumbar vertebrae / / / Epiphyseal ring / / / Imaging

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Xie Siyuan, Li Yikai, Lu Xiongguang, Cao Junjie, Liu Dan. Imaging characteristics of lumbar vertebral ring apophysis development in the Chinese population[J]. Chinese Journal of Clinical Anatomy. 2025, 43(6): 653-659 https://doi.org/10.13418/j.issn.1001-165x.2025.6.05

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