Die Bestimmung des Wachstumsspurtes anhand der Entwicklung der Halswirbel als Kriterium für die skelettale Reife.

The aim of this study was to investigate the relationship between the pubertal growth spurt and the maturational stage of the cervical vertebrae. Cervical vertebral maturation was assessed by the Lamparski method and, additionally, by the classification of San Roman. In the latter case a statistical regression analyses was performed. According to the San Roman classification, shape, concavity, and height were assessed separately. In addition, we investigated a bony vertebral ossification center that emerges during vertebral matura-tion and that later merges with vertebral body. Lateral cephalometric radiographs of two longitudinal studies performed in Groningen (the Netherlands) were used. Overall, 1538 digitized radiographs were available for assessment. Shape of vertebral bodies was examined on the PC-monitor and the stages of the two methods, including the ossification center, were assessed. In some cases skeletal age, esti-mated by the Greulich and Pyle method, was available. Mandibular length, represented by articulare-pogonion was determined on all radiographs. Reliability of both methods used and of the ossification center was assessed by repeating the procedure on 30 randomly selected radiographs. Results: 1) On the basis of hand-wrist radiographs, all cephalometric radiographs of subjects at the onset of their growth spurt (occurrence of the sesamoid bone) were selected. In this subgroup 75% of all males showed Lamparski stage 3 or 4 and 72,5% of all females showed stage 2 or 3. 2) At the onset of the growth spurt, the following observations were made with regard to the San Roman method and the ossification center. Concavity: in 87,6% of the male subjects stages 2 or 3 were found, whereas fe-males most often showed stage 1 (22,5%) and 2 (50%). Height: in both male and female subjects only stage 1 or 2 occurred. Shape: stage 3 occurred in 62,5% of the male and in 70% of the female subjects. 3) At the onset of the growth spurt, the ossification center was not visible or just bare-ly visible in nearly all male and female subjects. 4) The relationship between skeletal age and vertebral maturation was explored with multiple linear regression analysis. Including all variables in the equation: con-cavity, shape, height, and the ossification center, explained variance of skeletal age (R square or R2 value) was maximal (male R2 was 0,78 and for females it was 0,84.) Yet, the inclusion of only one or two variables also lead to high R2 values, indicating a strong correlation between these variables. 5) Regarding the longitudinal aspect of skeletal development in early and late matur-ing subjects, it could be shown that late maturing subjects tended to remain late in the course of their development. On the other hand, in only about half of the early maturing subjects the further development remained early, while in the other half a normalization of development occurred. 6) In only 12 subjects a clear mandibular growth spurt could be recognized. Half of these mandibular growth spurts occurred during stages 1 or 2 of Lamparski, in the other half the spurt occurred during stages 3 or 4.