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Related Experiment Videos

Refractory heterotopic ossification with complications.

K S Yin1, J James, K Lew

  • 1Department of Rehabilitation Medicine, VA Puget Sound Health Care System/University of Washington Medical Center, Seattle 98108, USA.

The Journal of Spinal Cord Medicine
|October 6, 2001
PubMed
Summary
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Heterotopic ossification (HO) after spinal cord injury is challenging. This case highlights refractory HO complicated by hypercoagulability, requiring aggressive, multi-modal treatment.

Area of Science:

  • Neuroscience
  • Orthopedics
  • Vascular Surgery

Background:

  • Spinal cord injury (SCI) can trigger heterotopic ossification (HO), leading to severe complications like deep venous thrombosis (DVT) and autonomic dysreflexia.
  • HO following SCI presents a significant clinical challenge, often refractory to standard treatments.
  • This case details a complex presentation of HO in a young adult with C8 incomplete tetraplegia.

Observation:

  • A 19-year-old male with C8 incomplete tetraplegia developed refractory HO.
  • Initial symptoms included leg swelling and fever, initially suspected as DVT but later diagnosed as HO compressing the external iliac vein.
  • The HO was further complicated by a state of hypercoagulability.

Findings:

  • Standard treatments including oral indomethacin and etidronate were ineffective.

Related Experiment Videos

  • Intravenous etidronate and local irradiation showed only transient or no significant response.
  • The patient exhibited persistent hypercoagulability despite various interventions.

    • Implications:

    • Early and accurate diagnosis of HO, differentiating it from DVT, is crucial.
    • Aggressive and multimodal treatment strategies are necessary for refractory HO.
    • Management of associated hypercoagulability is essential for improved outcomes in SCI patients with HO.