Study design: A case report and a review of literature. Objectives: To present the first youngest infant of a 4-month-old boy with spontaneous spinal epidural hematoma in cervicothoracic spine. Setting: National Cheng Kung University Hospital, Tainan, Taiwan. Methods: A 4-month-old boy who initially presented with irritable crying, neck stiffness, and fever followed by progressive quadriparesis. Magnetic resonance imaging (MRI) of the spine disclosed a space-occupying lesion on the right posterior-lateral aspect of the cervicothoracic spinal canal. Laminectomy with reconstruction in situ from C4 to T4 was performed 5 days after the onset of symptoms. Results: The boy had gradual improvement of his neurological status. Follow-up visit 1 year later, the infant's growth and development was within normal limit without any neurological deficits; his repeat MRI showed complete fusion of each implanted lamina and well expansion of the spinal cord. Conclusions: Prompt surgical decompression is valuable, irrespective of the time interval between symptom onset and operation in infant.
To investigate the pattern of age-related and sex-dependent bone mineral density (BMD) changes in the six skeletal regions in healthy Chinese, total-body and regional BMD were measured by dual-energy X-ray absorptiometry (DXA) in 310 women and 387 men aged 20-80 years. In women, a five-phase change was discernible in the axial bones: (1) gradual bone increase from 20-29 years old to maximal BMD at 35-39 years old; (2) maintenance of this level from 35-39 to 40-44; (3) a mild bone decrease from 40-44 to 45-49; (4) a rapid bone decrease from 45-49 to 55-59; and (5) a decelerated bone decrease after 55-59 years old. After validation of menopause status, the decrease of BMD in the late 40s became insignificant in premenopausal women. In appendicular bones, no obvious peak was observed, and significant bone decrease started at 50-54 years old. The overall bone decrease from 35-39 to 70-80 years old was 19.3% for the total body, 16.4% for the head, 29% for the spine, 23% for the pelvis, 18.2% for the ribs, 23.9% for the arms, and 20.4% for the legs. In men, the maximal bone mass was attained at 30-34 and 35-39 years old for axial and appendicular bones, respectively. The age-related bone decrease in the skeletal regions was small, except from 60-64 to 65-69 years old. The overall bone decrease in each region from maximal bone mass to 70-80 years old was 6.7% for the total body, 1.7% for the head, 7.6% for the spine, 11.3% for the pelvis, 9.5% for the ribs, 7.8% for the arms, and 10.4% for the legs. The overall magnitude of reduction in total-body BMD in women was about three times greater than that in men. The pattern of BMD changes differs in each region and is age-related as well as sex-dependent. There appeared to be no significant premenopausal bone decrease.
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