Related Experiment Videos
Warfarin in prevention of heterotopic ossification
R Buschbacher1, W McKinley, L Buschbacher
1Department of Physical Medicine and Rehabilitation, Medical College of Virginia, Richmond 23298-0677.
Insights
Warfarin may prevent neurogenic heterotopic ossification in spinal cord injury patients. This study suggests warfarin inhibits ectopic bone formation, offering a potential new treatment to reduce patient morbidity.
Area of Science:
- Orthopedics
- Neurology
- Pharmacology
Background:
- Neurogenic heterotopic ossification (HO) is a common complication in spinal cord injury (SCI) patients.
- Current treatments like disodium etidronate (Didronel) are insufficient, inhibiting mineralization but not matrix production.
- More effective prophylactic treatments are needed to reduce morbidity and cost.
Purpose of the Study:
- To investigate the potential of warfarin as a prophylactic treatment for neurogenic HO in SCI patients.
- To explore the link between vitamin K-dependent carboxylation and ectopic bone formation.
Main Methods:
- Retrospective review of 227 spinal cord injury cases.
- Analysis of HO development in patients treated with warfarin versus those not treated.
Main Results:
- 15% of SCI patients developed heterotopic ossification.
- None of the patients treated with warfarin developed heterotopic ossification.
- Warfarin treatment was associated with a lack of HO development.
Conclusions:
- Warfarin shows promise in inhibiting the formation of ectopic bone in SCI patients.
- Further prospective studies are warranted to confirm warfarin's efficacy in preventing neurogenic HO.
Abstract:
Patients with spinal cord injuries among others, commonly develop neurogenic heterotopic ossification. Current treatment with Didronel (disodium etidronate) inhibits bone matrix mineralization but not matrix production. To eliminate much morbidity and cost, a more efficatious prophylactic treatment is desirable. Because one of the proteins in bone, osteocalcin, is produced by a vitamin K-dependent carboxylation, this raises the possibility that treatment with warfarin may prevent the formation of ectopic bone. In the present study, 227 cases of spinal cord injury were reviewed. Among these patients, 15% were treated with warfarin and another 15% developed heterotopic ossification. None of the patients who were treated with warfarin developed heterotopic ossification, thus suggesting that warfarin may inhibit heterotopic ossification. Further prospective studies are planned.