Prevention and treatment of heterotopic ossification after spinal cord injury

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Article discusses the etiology, prevention, and clinical management of heterotopic ossification (HO) after spinal cord injury (SCI). Although the cause of HO after SCI remains unknown, trauma and overexpression of bone morphogenic proteins in traumatized soft tissue appear to play important roles. Preventive use of nonsteroidal antiinflammatory drugs (NSAIDs) reduces the incidence and severity of HO. Patients who develop symptoms of HO should have a bone scintigraphy. Those patients with positive scintigraphic findings of HO should be tested for serum creatine phosphokinase (CPK) and C-reactive protein (CRP) levels. Regardless of the CPK level, all patients with positive bone scintigraphy require NSAID treatment until serum CRP is normalized.

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