Abstract
Background/Objectives: Heterotopic ossification (HO) is a frequent, irreversible complication after spinal cord injury (SCI). The objective of this article is to explain the etiology of HO; present new advances in prevention, diagnosis, and management of this complication; and provide a suggested algorithm for clinical management. Etiology: Although still hypothetical, trauma and overexpression of bone morphogenic protein(s) in traumatized soft tissue appear to play important roles as initiating factors of HO. Prevention: Preventive use of nonsteroidal antiinflammatory agents (NSAIDs) reduces the incidence of HO by a magnitude of 2 to 3. Management: Early determination of serum creatine phosphokinase may have a diagnostic value in predicting the onset and severity of HO, and an NSAID may be added to etidronate therapy in the initial inflammatory phase of HO formation until C-reactive protein levels return to normal range. Surgery is indicated in a subset of patients, and a regimen that includes radiation therapy may prevent postoperative recurrence. Conclusion: Significant progress has been made in the early prevention and management of HO. Further studies are needed to elucidate the etiology.
| Original language | English |
|---|---|
| Pages (from-to) | 376-382 |
| Number of pages | 7 |
| Journal | Journal of Spinal Cord Medicine |
| Volume | 27 |
| Issue number | 4 |
| State | Published - Dec 1 2004 |
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Keywords
- C-reactive protein
- Creatine phosphokinase
- Etidronate
- Heterotopic ossification
- NSAID
- Prevention
- Roficoxib
- Spinal cord injuries
ASJC Scopus subject areas
- Clinical Neurology
Cite this
Prevention and treatment of heterotopic ossification after spinal cord injury. / Banovac, Kresimir; Sherman, Andrew L.; Estores, Irene M.; Banovac, Filip.
In: Journal of Spinal Cord Medicine, Vol. 27, No. 4, 01.12.2004, p. 376-382.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prevention and treatment of heterotopic ossification after spinal cord injury
AU - Banovac, Kresimir
AU - Sherman, Andrew L.
AU - Estores, Irene M.
AU - Banovac, Filip
PY - 2004/12/1
Y1 - 2004/12/1
N2 - Background/Objectives: Heterotopic ossification (HO) is a frequent, irreversible complication after spinal cord injury (SCI). The objective of this article is to explain the etiology of HO; present new advances in prevention, diagnosis, and management of this complication; and provide a suggested algorithm for clinical management. Etiology: Although still hypothetical, trauma and overexpression of bone morphogenic protein(s) in traumatized soft tissue appear to play important roles as initiating factors of HO. Prevention: Preventive use of nonsteroidal antiinflammatory agents (NSAIDs) reduces the incidence of HO by a magnitude of 2 to 3. Management: Early determination of serum creatine phosphokinase may have a diagnostic value in predicting the onset and severity of HO, and an NSAID may be added to etidronate therapy in the initial inflammatory phase of HO formation until C-reactive protein levels return to normal range. Surgery is indicated in a subset of patients, and a regimen that includes radiation therapy may prevent postoperative recurrence. Conclusion: Significant progress has been made in the early prevention and management of HO. Further studies are needed to elucidate the etiology.
AB - Background/Objectives: Heterotopic ossification (HO) is a frequent, irreversible complication after spinal cord injury (SCI). The objective of this article is to explain the etiology of HO; present new advances in prevention, diagnosis, and management of this complication; and provide a suggested algorithm for clinical management. Etiology: Although still hypothetical, trauma and overexpression of bone morphogenic protein(s) in traumatized soft tissue appear to play important roles as initiating factors of HO. Prevention: Preventive use of nonsteroidal antiinflammatory agents (NSAIDs) reduces the incidence of HO by a magnitude of 2 to 3. Management: Early determination of serum creatine phosphokinase may have a diagnostic value in predicting the onset and severity of HO, and an NSAID may be added to etidronate therapy in the initial inflammatory phase of HO formation until C-reactive protein levels return to normal range. Surgery is indicated in a subset of patients, and a regimen that includes radiation therapy may prevent postoperative recurrence. Conclusion: Significant progress has been made in the early prevention and management of HO. Further studies are needed to elucidate the etiology.
KW - C-reactive protein
KW - Creatine phosphokinase
KW - Etidronate
KW - Heterotopic ossification
KW - NSAID
KW - Prevention
KW - Roficoxib
KW - Spinal cord injuries
UR - http://www.scopus.com/inward/record.url?scp=7944229172&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=7944229172&partnerID=8YFLogxK
M3 - Article
C2 - 15484668
AN - SCOPUS:7944229172
VL - 27
SP - 376
EP - 382
JO - Journal of Spinal Cord Medicine
JF - Journal of Spinal Cord Medicine
SN - 1079-0268
IS - 4
ER -