Incidence and characteristics of heterotopic ossification after spinal cord injury: a single institution study in India

Rawat, Nidhi; Chugh, Sushil; Zachariah, Kurian; Ghosh, Santu

doi:10.1038/s41394-019-0216-6

Cited by 10 publications

(3 citation statements)

References 8 publications

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“…The found incidence is lower than in previous publications (around 20%; Goldman, 1980 ). This discrepancy is probably due to a selection bias based on the retrospective character of the HO evaluation, the availability of complete datasets, and the fact that previous studies were characterized by a rather unselective inclusion of individuals with acute SCI (Lal et al, 1989 ; Krauss et al, 2015 ; Rawat et al, 2019 ). The rather high median age of 56 years in the HO cohort compared with previous reports (Wittenberg et al, 1992 ) is likely attributable to the same bias since eligible individuals with HO who had to be excluded were younger.…”

Section: Discussionmentioning

confidence: 99%

Impact of Heterotopic Ossification on Functional Recovery in Acute Spinal Cord Injury

Franz

Rust

Heutehaus

et al. 2022

Front. Cell. Neurosci.

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Objective: In spinal cord injury (SCI), heterotopic ossification is a frequent secondary complication, commonly associated with limited range of motion of affected joints, which could lead to secondary disability in activities of daily living. Additionally, heterotopic ossifications might challenge the effect of regeneration-promoting therapies on neurological and functional recovery. This study evaluated the impact of heterotopic ossification on clinical recovery within the first year after SCI.Methods: The study was conducted as a monocentric longitudinal paired cohort study. Recruitment was based on consecutive sampling in the framework of the European Multicenter about Spinal Cord Injury (EMSCI). Recovery profiles were determined using standardized neurological and functional clinical assessments within the 1st year following SCI. All study participants underwent at least two comprehensive standardized neurological and functional clinical examinations according to the International Standards for Neurological Classification of SCI and the Spinal Cord Independence Measure, respectively. Data regarding the diagnosis and treatment of heterotopic ossification were obtained by reviewing the patient medical records. The most similar “digital twin” from the entire EMSCI database were matched in terms of age, acute neurological and functional status to each individual with SCI, and heterotopic ossification.Results: Out of 25 participants diagnosed with heterotopic ossification, 13 individuals were enrolled and matched to control individuals. Most individuals presented with motor complete injury (75%). Ossifications were most frequently located at the hip joints (92%) and mainly occurred within the first 3 months after SCI. Individuals with heterotopic ossification achieved around 40% less functional improvement over time compared to their matched counterparts, whereas neurological recovery was not altered in individuals with SCI and heterotopic ossification.Conclusion: Heterotopic ossification—a common complication of SCI—unfavorably affects functional recovery, which in the end is most relevant for the best possible degree of independence in activities of daily living. Upon presentation with heterotopic ossification, neurological improvement achieved through potential restorative therapies might not translate into clinically meaningful functional improvement. Diagnostic algorithms and effective early prevention/treatment options for heterotopic ossification need to be established to ensure the best possible functional outcome.Clinical Trial Registration: NCT01571531 (https://clinicaltrials.gov).

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Section: Discussionmentioning

confidence: 99%

Impact of Heterotopic Ossification on Functional Recovery in Acute Spinal Cord Injury

Franz

Rust

Heutehaus

et al. 2022

Front. Cell. Neurosci.

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“…NHO prevalence in SCI patients has been estimated to be between 10% and 53% [6]. In the study of Rawat et al, 6.3% of SCI patients developed HO, mostly at the hip joint [6].…”

Section: Review Epidemiologymentioning

confidence: 99%

New Strategies in Neurogenic Heterotopic Ossification

Ampadiotaki¹,

Evangelopoulos²,

Pallis³

et al. 2021

Cureus

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“…Пролежни, по мнению N. Rawat и соавт., служат причиной развития локального воспалительного процесса, что может быть пусковым механизмом формирования НГО у пациентов с последствиями ПСМТ [23]. Однако ряд авторов считает, что далеко не у всех пациентов с пролежнями на фоне ПСМТ возникают НГО [18,24].…”

Section: результаты и обсуждение эпидемиология и факторы рискаunclassified

Neurogenic heterotopic ossification: A review. Part 1

Khodorovskaya,

Novikov,

Umnov

et al. 2023

Pediatr Traum Orthop Reconstr Surg

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BACKGROUND: Heterotopic ossification is the formation of bone tissues in the soft tissues of the body. A distinct form of heterotopic ossification is neurogenic, that is, resulting from severe injury to the brain or spinal cord of different genesis. Neurogenic heterotopic ossification is a complex multifactorial process of differentiated bone formation in the paraarticular soft tissues of large joints. Heterotopic ossification leads to the formation of persistent contractures and ankylosis, which cause severe disability and complicate rehabilitation. AIM: To analyze publications dealing with various aspects of neurogenic heterotopic ossification. MATERIALS AND METHODS: In the first part of our review, we present the results of the literature analysis on the epidemiology, risk factors, pathogenesis, and clinic and laboratory diagnosis of neurogenic heterotopic ossification. Scientific literature databases PubMed, Google Scholar, Cochrane Library, Crossref, and eLibrary were searched for without language limitations. RESULTS: Current literature data on heterotopic ossification in patients with central nervous system pathologies are presented. Topical questions of etiology, risk factors, pathogenesis, and clinic and laboratory diagnostics of this pathological process are highlighted. CONCLUSIONS: Understanding the risk factors of heterotopic ossification development and their prevention in the context of the modern knowledge of heterotopic ossification pathogenesis may help reduce the incidence of heterotopic ossification in patients with severe central nervous system injury.

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Incidence and characteristics of heterotopic ossification after spinal cord injury: a single institution study in India

Cited by 10 publications

References 8 publications

Impact of Heterotopic Ossification on Functional Recovery in Acute Spinal Cord Injury

Impact of Heterotopic Ossification on Functional Recovery in Acute Spinal Cord Injury

New Strategies in Neurogenic Heterotopic Ossification

Neurogenic heterotopic ossification: A review. Part 1

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