HETEROTOPIC OSSIFICATION AFTER SPINAL CORD INJURY: PREVENTION AND TREATMENT - A SISTEMATIC REVIEW

ABSTRACT Trauma configures the main cause of spinal cord injuries. Patients with traumatic spinal cord injury often develop severe and debilitating outcomes that require multidisciplinary care to adapt patients to their new reality. Heterotopic ossification (HO) is one of the frequent comorbidities in these patients but it still lacks well-established treatments or a gold standard one. Thus, this systematic review aimed to search the current literature for HO treatment and prevention. This study was conducted following PRISMA recommendations (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) and searches were conducted in three databases (PubMed, Embase, and Web of Science). A total of 193 articles were found in an initial search. After screening following the established criteria, eight articles were included in this review; of these, two reported prevention and the others, treatments. Based on data analysis, the use of non-steroidal anti-inflammatory drugs in the acute post-traumatic period proved to be the best method of prevention. In cases of mature HO or accompanied by ankylosis, surgical resection proved to be the most effective treatment despite the high rate of postoperative infections. Level of Evidence III, Systematic Review.

摘要：创伤是脊髓损伤的主要原因。遭受创伤性脊髓损伤的患者常常会发展出严重且致残的后果，这需要多学科的治疗来帮助患者适应其新的生活现实。异位骨化（HO）是这些患者中常见的合并症之一，但至今仍缺乏确立的治疗方法或金标准。因此，本系统评价旨在检索当前文献中关于HO的治疗和预防方法。本研究遵循PRISMA推荐（系统评价和荟萃分析优先报告项目）进行，并在三个数据库（PubMed、Embase和Web of Science）中进行了搜索。初步搜索中共发现193篇文章。经过按照既定标准筛选后，本评价中纳入了八篇文章；其中两篇报道了预防措施，其余则涉及治疗方法。根据数据分析，急性创伤后期间使用非甾体抗炎药被认为是预防的最佳方法。在成熟的异位骨化或伴有骨性强直的情况下，尽管术后感染率较高，但手术切除仍被证明是最有效的治疗方法。证据等级：III级，系统评价。