A new golden ratio for foramen magnum in pre- and post-adolescent children.

The foramen magnum (FM) is a crucial transition zone between the skull and spine, with its growth mostly completed by the end of the age of four. A study on adults reported that the ratio of the anteroposterior to transverse diameter of the FM and skull aligns with the golden ratio (4.62), suggesting a harmonious relationship. Our study aims to investigate whether this ratio is present in children by analyzing Computed Tomography (CT) images, and whether FM shape variations affect this ratio. We analyzed CT images of 201 Turkish children (male: 117, female: 84), measuring maximum cranial length (MCL), width (MCW), foramen magnum length (FML), and width (FMW). Group comparisons were made using the Independent t-test and ANOVA. Relationships between continuous variables were examined using Pearson correlation analysis. Ratios of MCW to FMW and MCL to FML were consistent in children aged 6-17. The ratio of 4.90 obtained from these parameters observed between the skull and FM reveals the presence of a unique anatomical balance in the skull. FM shapes were classified morphologically, with their frequency and incidence recorded. For categorical variables, associations were analyzed using the Chi-Square test. A total of 12 distinct FM shapes were identified, with the two semicircle shape being the most prevalent, appearing in 32.8% of cases. In contrast, the pentagonal and triangular shapes were the rarest, each representing only 0.5% of the cases. Recalculating these ratios across different FM shapes may provide a clearer understanding of the validity of the golden ratio.