No abstract

Prolonged fever is an uncommon diagnostic problem in a spinal cord injury patient. The underlying causes include recurrent infections, thromboembolic phenomena and central fever. We report a case of heterotopic ossification in a traumatic C4 tetraplegic patient presenting as prolonged fever of 3 months' duration. Treatment with oral indomethacin led to prompt resolution of the fever and acute manifestations of heterotopic ossification. The efficacy of indomethacin in the treatment of heterotopic ossification in spinal cord injury needs to be further confirmed in larger studies.

In this prospective study, we surveyed the pain experience of 40 participants during the in-patient rehabilitation period following traumatic spinal cord injury (SCI). Twenty-eight patients (70% of the study population) had musculoskeletal (MS) pain or neuropathic (NP) pain. Pain responded positively to physical therapy and analgesics. A numerical pain scale decreased from a mean of 6.36+/-1.7 on admission to 3.2+/-1.94 on discharge (P<0.001). Paraplegic patients were more likely to have MS pain (P=0.001) and NP pain (P=0.046). There was no relationship between completeness of injury, or spinal surgery, and type of pain encountered. There was also no significant difference in the modified Barthel index between patients with and without pain on admission and discharge. We conclude that pain is a common experience in SCI patients and that it can be reduced significantly by the end of in-patient rehabilitation.