Patterns of normal bone marrow distribution in the spine
Patterns of normal bone marrow distribution in the spine have been described by Ricci . They apply to patients from the age of 6 months.
Gross anatomy
There are four patterns of normal red and yellow bone marrow distribution, with great variability not only between patients, but between respective spinal segments in a particular patient as well. The evolution of the infantile homogenous red marrow into pattern 1 is a constant feature of a normal pediatric marrow. The rest of the patterns are present in older individuals and do not follow any predictable evolution path.
Classification
- yellow marrow visible around the basivertebral veins
- common in younger patients
- may persist for years
- band-like and triangular-like areas of yellow marrow in the vertebral body corners and adjacent to the endplates
- may be affected by degenerative changes of the adjacent disc
- speckled pattern: punctate foci of red and yellow bone marrow
- larger areas of yellow marrow and poorly circumscribed areas of red marrow
Practical points
The knowledge of all four patterns is important in order to avoid mistaking them with spinal bone marrow pathology.