Abstract
Study design:
Retrospective chart review.
Objectives:
Heterotopic ossification (HO) affecting the hips is a common complaint of patients suffering traumatic spinal cord injury. However, the incidence of HO of the shoulder is considerably rare. In this context, we report on our results of 13 patients with a total of 21 cases of shoulder HO and single-dose radiation therapy.
Setting:
Department of Spinal Cord Injury and Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil Bochum, Ruhr-University Bochum, Germany.
Methods:
The study group consists of 12 male and 1 female patient with a mean age of 55.5 years (range from 24 to 81 years; s.d.=14.5). Primary outcome measures were defined as the number of HO relapses and the number of side or adverse effects in relation to the radiation therapy.
Results:
At the time of latest follow-up during hospitalization, the mean shoulder flexion was 92.1° while mean abduction was 94.5°. The average external rotation was 26.4°. No HO recurrence occurred and none of the patients suffered any adverse effects related to radiation therapy.
Conclusions:
In conclusion, single-dose radiation therapy in the treatment of shoulder HO due to spinal cord injury is an effective and reliable method, although the risk of secondary side effects related to the radiation therapy remain unknown.
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References
Kedlaya D, Nazir C . Heterotopic ossification with normal serum alkaline phosphatase levels: a case series. Arch Phys Med Rehabil 2005; 86: E44.
Citak M, Kendoff D, O'Loughlin PF, Pearle AD . Heterotopic ossification post navigated high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 2009; 17: 352–355.
Wittenberg RH, Peschke U, Botel U . Heterotopic ossification after spinal cord injury. Epidemiology and risk factors. J Bone Joint Surg Br 1992; 74: 215–218.
Sautter-Bihl ML, Hultenschmidt B, Liebermeister E, Nanassy A . Fractionated and single-dose radiotherapy for heterotopic bone formation in patients with spinal cord injury. A phase-I/II study. Strahlenther Onkol 2001; 177: 200–205.
Genet F, Kulina I, Vaquette C, Torossian F, Millard S, Pettit AR et al. Neurological heterotopic ossification following spinal cord injury is triggered by macrophage-mediated inflammation in muscle. J Pathol 2015; 236: 229–240.
Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr . Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 1973; 55: 1629–1632.
Maynard FM Jr, Bracken MB, Creasey G, Ditunno JF Jr, Donovan WH, Ducker TB et al. International Standards for Neurological and Functional Classification of Spinal Cord Injury. American Spinal Injury Association. Spinal Cord 1997; 35: 266–274.
Kim JH, Chu FC, Woodard HQ, Melamed MR, Huvos A, Cantin J . Radiation- induced soft-tissue and bone sarcoma. Radiology 1978; 129: 501–508.
Ron E, Modan B, Boice JD Jr, Alfandary E, Stovall M, Chetrit A et al. Tumors of the brain and nervous system after radiotherapy in childhood. N Engl J Med 1988; 319: 1033–1039.
Citak M, Suero EM, Backhaus M, Meindl R, Schildhauer TA . Rhabdomyolysis after heterotopic ossification: an unusual complication in a spinal cord injured patient. Eur Spine J 2012; 21 (Suppl 4): S531–S534.
Sautter-Bihl ML, Liebermeister E, Heinze HG, Nanassy A, Stoltze D . The radiotherapy of heterotopic ossifications in paraplegics. The preliminary results. Strahlenther Onkol 1995; 171: 454–459.
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Citak, M., Grasmücke, D., Cruciger, O. et al. Heterotopic ossification of the shoulder joint following spinal cord injury: an analysis of 21 cases after single-dose radiation therapy. Spinal Cord 54, 303–305 (2016). https://doi.org/10.1038/sc.2015.182
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DOI: https://doi.org/10.1038/sc.2015.182
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