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Critical Reviews™ in Physical and Rehabilitation Medicine

Publicou 4 edições por ano

ISSN Imprimir: 0896-2960

ISSN On-line: 2162-6553

SJR: 0.141 SNIP: 0.129 CiteScore™:: 0.6 H-Index: 18

Indexed in

Heterotopic Ossification After Brain and Spinal Cord Injury

Volume 10, Edição 3, 1998, pp. 223-256
DOI: 10.1615/CritRevPhysRehabilMed.v10.i3.20
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RESUMO

Heterotopic ossification (HO) is a soft tissue ossification commonly found after SCI and TBI. The incidence of HO after SCI is about 50%, after TBI is 20%. The etiology is unknown. The pathology of HO is characterized by an extra-articular localization in paralyzed extremities. In the acute stage of HO microscopic evaluation reveals edema, woven bone, numerous small vessels and fibroblasts. In the later stage HO contains lamellar bone with cortical and trabecular architecture. Clinically, in the acute stage of HO most common findings are swelling of soft tissue, reduction of ROM in affected joint and fever. In the chronic stage HO may limit functional status of patients. In the early stage the diagnosis of HO is based on three-phase bone scintigraphy with 99m-Tc diphosphonate. In the chronic stages when HO contains mature bone the radiographic examination is a diagnostic test. Prevention of HO in patients with TBI and SCI is effective if started early after injury. Etidronate in doses of 20 mg/kg/day for 3 months will significantly reduce the incidence of HO in both groups of patients. Treatment of HO in acute phase is etidronate therapy and physical therapy, at the stage of mature bone the management of HO is in the domain of orthopedic surgery.

CITADO POR
  1. Banovac Kresimir, Sherman Andrew L., Spinal Cord Injury Rehabilitation, in Rothman Simeone The Spine, 2011. Crossref

  2. Knight Lisa A, Thornton Heather A, Turner-Stokes Lynne, Management of Neurogenic Heterotopic Ossification, Physiotherapy, 89, 8, 2003. Crossref

  3. Kirshblum Steven, Donovan Jayne, Medical Complications of Spinal Cord Injury: Bone, Metabolic, Pressure Ulcers, and Sexuality and Fertility, in Neurological Aspects of Spinal Cord Injury, 2017. Crossref

  4. Banovac K, Williams JM, Patrick LD, Haniff YM, Prevention of heterotopic ossification after spinal cord injury with indomethacin, Spinal Cord, 39, 7, 2001. Crossref

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