Heterotopic ossification after central nervous system trauma: A current review

Area of Science:

• Orthopedics
• Neurology
• Regenerative Medicine

Background:

• Neurogenic heterotopic ossification (NHO) is a frequent complication following spinal cord injury (SCI) and traumatic brain injury (TBI).
• Ectopic bone formation around joints causes significant pain, restricts range of motion, and leads to severe functional impairment.
• Associated clinical issues include infections and pressure sores, highlighting the need for effective early interventions.

Purpose of the Study:

• To review the current understanding of NHO pathophysiology.
• To discuss current diagnostic challenges and treatment modalities.
• To emphasize the need for improved diagnostic and therapeutic strategies.

Main Methods:

• Literature review of pathophysiological mechanisms of NHO.
• Analysis of current prophylactic and therapeutic interventions for NHO.
• Synthesis of current evidence to guide future research and clinical practice.

Main Results:

• NHO affects approximately 20% of patients with SCI or TBI, with characteristic patterns of ectopic bone formation.
• Diagnosis of NHO is challenging, requiring further investigation and improved methods.
• Current treatments include NSAIDs, bisphosphonates, radiation, and surgery, with ongoing research into novel approaches.

Conclusions:

• Understanding the basic bone formation mechanisms and systemic influences is key to managing NHO.
• Improved diagnostic tools and targeted therapies are essential for better patient outcomes.
• Future research should focus on elucidating underlying mechanisms to develop more effective NHO treatments.