Summary
Submitted by admin on Thu, 05/20/2010 - 00:00
- Schuetz and coworkers (2005) note that after a SCI, heterotopic ossification still remains a therapeutic challenge. Anti-inflammatory medications provided early prevent the development of HO while warfarin was associated with a decreased risk of HO. Both radiotherapy and etidronate appear to halt the progression of HO once it is diagnosed. Although more research is needed, early work is encouraging demonstrating that HO post SCI is treatable.
- There is strong Level 1a evidence that non-steroidal anti-inflammatory medications can reduce the incidence of heterotopic ossification when administered early after a spinal cord injury.
- There is Level 5 evidence that Warfarin inhibits the development of heterotopic ossification post spinal cord injury.
- There is Level 2 evidence that etidronate can stop the progression of heterotopic ossification once the diagnosis is made; it is most effective if given when  the nuclear bone scan is positive but the radiographs are negative.
- There is Level 4 evidence that Etidronate is not effective once radiographs are positive for HO.
- There is Level 4 evidence that pamidronate effectively halts secondary HO progression after surgical resection of HO.
- There is Level 1b evidence that PLIMF is an effective prophylaxis of HO post SCI
- There is limited Level 4 evidence that radiotherapy reduces the progression of heterotopic ossification.
- There is level 4 evidence that resection of HO about the hip post SCI can dramatically improve restricted hip range of motion.
- There is Level 4 evidence that surgical resection combined with pamidronate treatment effectively halts secondary progression of HO.
