Risk factors for heterotopic ossification in spinal cord injury

Area of Science:

• Neurology
• Orthopedics
• Rehabilitation Medicine

Background:

• Heterotopic ossification (HO) is a common complication following spinal cord injury (SCI), affecting up to 53% of patients.
• Moderate to severe HO can significantly impair function and health in SCI patients.
• Current prophylactic treatments for HO in SCI are controversial, and risk factors from other conditions do not apply.

Purpose of the Study:

• To identify specific risk factors for heterotopic ossification (HO) in patients with spinal cord injury (SCI).
• To determine if specific demographic and medical variables can predict high-risk individuals for HO development after SCI.

Main Methods:

• Retrospective review of medical charts for 100 randomly selected SCI patients (50 with HO, 50 without HO).
• Analysis of 14 variables: 7 demographic (age, sex, race, lesion level, lesion completeness, injury cause, geographic locus) and 7 medical (bladder stones, fractures, pressure sores, deep vein thrombosis, pulmonary embolism, spasticity, urinary tract infections).

Main Results:

• Four variables were significantly associated with HO formation: age, completeness of the lesion, presence of pressure sores, and spasticity.
• These risk factors appear to be additive, with 92% of patients having HO when all four factors were present.
• No specific risk factors for HO in SCI were previously identified in the literature.

Conclusions:

• Age, lesion completeness, pressure sores, and spasticity are significant predictors of HO in SCI patients.
• These identified risk factors may help in stratifying SCI patients for HO risk.
• Further prospective studies are recommended to validate the predictive value of these factors in clinical practice.