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Radiotherapy for Non-Malignant Disorders pp 373–381Cite as

Heterotopic Ossifications after Head and Spinal Cord Injuries (HSCI)

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Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

Abstract

Progress in medical care has improved the prognosis for patients with head and spinal cord injuries (HSCI) [28]. However, the clinical outcome may be compromised by various complications: these patients are at risk for urinary tract infections, thrombo-embolism, respiratory diseases and especially for the production of heterotopic bone or heterotopic ossification (HO), in the neighborhood of joints, preferentially the hips [27, 50, 54] (Table 20.1).

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References

  1. Anthony P, Keys H, Evarts CM et al (1987) Prevention of heterotopic bone formation. Int J Radiat Oncol Biol Phys 13:365–369

    PubMed  CAS  Google Scholar 

  2. Banovac K, Gonzalez F, Wade N et al (1993) Intravenous disodium etidronate therapy in spinal cord injury patients with heterotopic ossification. Paraplegia 31:660–666

    PubMed  CAS  Google Scholar 

  3. Banovac K (2000) The effect of etidronate on late development of heterotopic ossification after spinal cord injury. Spinal Cord 23:40–44

    CAS  Google Scholar 

  4. Banovac K, Williams JM, Patrick LD et al (2001) Prevention of heterotopic ossification after spinal cord injury with indomethacin. Spinal Cord 39:370–374

    Article  PubMed  CAS  Google Scholar 

  5. BEIR (1990) Health effects of exposure to low levels of ionizing radiation. National Academy Press, Washington DC

    Google Scholar 

  6. Bodley R, Jamous A, Short D (1993) Ultrasound in the early diagnosis of heterotopic ossifications in patients with spinal cord injuries. Paraplegia 31:500–506

    PubMed  CAS  Google Scholar 

  7. Bosse A, Kresse H, Schwarz K et al (1994) Immunohistochemical characterization of the small proteoglycans decorin and proteoglycan-100 in heterotopic ossification. Calcif Tissue Int 54:119–124

    Article  Google Scholar 

  8. Brady LW (1979) Radiation induced sarcomas of bone. Skel Radiol 4:72–78

    CAS  Google Scholar 

  9. Bravo-Payno P (1992) Incidence and risk factors in the appearance of heterotopic ossification in spinal cord injury. Paraplegia 30:740–745

    PubMed  CAS  Google Scholar 

  10. Bressler EL, Marn CS, Gore RM et al (1987) Evaluation of ectopic bone by CT. AJR Am J Roentgenol 148:931–935

    PubMed  CAS  Google Scholar 

  11. Brooker, A F, Bowerman, JW, Robinson, RA et al (1973) Ectopic ossification following total hip replacement. J Bone Joint Surg 55:1629–1632

    PubMed  CAS  Google Scholar 

  12. Buring K (1975) On the origin of cells in heterotopic bone formation. Clin Orthop 110:293–302

    Article  PubMed  Google Scholar 

  13. Cassar-Pullicino VN, Mc Clelland M, Badwan DAH et al (1993) Sonographic diagnosis of heterotopic bone formation in spinal injury patients. Paraplegia 31:40–50

    PubMed  CAS  Google Scholar 

  14. Chantraine A, Nusgens B, Lapiere CM (1995) Biochemical analysis of heterotopic ossification in spinal cord injury patients. Paraplegia 33:398–401

    PubMed  CAS  Google Scholar 

  15. Colachis SC, Clinchot DM (1993) The association between deep venous thrombosis and heterotopic ossification in patients with acute traumatic spinal cord injury. Paraplegia 31:507–512

    PubMed  Google Scholar 

  16. Craven PL, Urist MR (1971) Osteogenesis by radioisotope labeled cell populations in implants of bone matrix under the influence of ionizing radiation. Clin Orthop 76:231–243

    Article  PubMed  CAS  Google Scholar 

  17. Daud O, Sett P, Burr RG et al (1993) The relationship of heterotopic ossification to passive movements in paraplegic patients. Disabil Rehabil 15:114–118

    Article  PubMed  CAS  Google Scholar 

  18. Dejerine M, Ceillier A (1918) Para-Osteo-Arthropathie des paraplegiques parlesions medullaires. Ann Med Paris 5:497–535

    Google Scholar 

  19. De Smet AA, Norris MA, Fisher DR (1992) Magnetic resonance imaging of myositis ossificans: Analysis of seven cases. Skeletal Radiol 21:503–507

    PubMed  Google Scholar 

  20. Freed JH, Hahn H, Menter MD et al (1982) The use of three phase bone scan in the early diagnosis of heterotopic ossification (HO) and the evaluation of didronel therapy. Paraplegia 20:208

    PubMed  CAS  Google Scholar 

  21. Freebourn TM, Barber DB, Able AC (1999) The treatment of heterotopic ossification in spinal cord injury with combination surgery, radiation and NSAID. Spinal Cord 37:50–53

    Article  PubMed  CAS  Google Scholar 

  22. Garland DE (1991) A clinical perspective on common forms of acquired heterotopic ossification. Clin Orthop 263:13–29

    PubMed  Google Scholar 

  23. Gregoritch SJ, Chadha M, Pellegrini VD et al (1994) Randomized trial comparing preoperative versus postoperative irradiation for prevention of heterotopic ossification following prosthetic total hip replacement: Preliminary results. Int J Radiat Oncol Biol Phys 30:55–62

    PubMed  CAS  Google Scholar 

  24. Greiner R (1982) Die Erholung der Spermatogenese nach fraktionierter, niedrigdosierter Bestrahlung der männlichen Gonaden. Strahlenther Onkol 158:342–355

    CAS  Google Scholar 

  25. Hernandez AM, Forner JV, De la Fuente T et al (1978) The paraarticular ossifications in our paraplegics and tetraplegics: a survey of 704 patients. Paraplegia 16:272–275

    PubMed  CAS  Google Scholar 

  26. International Commission on Radiological Protection: Recommendations (1990) Annals of the ICRP, no. 60. Pergamon Press, Oxford

    Google Scholar 

  27. Jensen LL, Halar E, Little JW et al (1987) Neurogenic heterotopic ossification. Am J Phys Med 66:351–363

    PubMed  CAS  Google Scholar 

  28. Kalisky Z, Morrison DP, Meyers CA et al (1985) Medical problems encountered during rehabilitation of patients with head injury. Arch Phys Med Rehabil 66:25–29

    PubMed  CAS  Google Scholar 

  29. Kim SW, Charter RA, Chai CJ et al (1990) Serum alkaline phosphatase and inorganic phosphorous values in spinal cord injury patients with heterotopic ossification. Paraplegia 28:441–447

    PubMed  CAS  Google Scholar 

  30. Kim SW, Wu SY, Kim RC (1992) Computerized quantitative radionuclide assessmant of heterotopic ossification in spinal cord injury patients. Paraplegia 30:803–807

    PubMed  CAS  Google Scholar 

  31. Kölbl O, Knelles D, Barthel T et al (1998) Preoperative irradiation versus the use of nonsteroidal antiinflammatory drugs for prevention of heterotopic ossification following total hip replacement: the results of a randomized trial. Int J Radiat Oncol Biol Phys 42:397–401

    PubMed  Google Scholar 

  32. Konski A, Pellegrini V, Poultier C et al (1990) Randomized trial comparing single dose versus fractionated irradiation for prevention of heterotopic bone: a preliminary report. Int J Radiat Oncol Biol Phys 18:1139–1142

    PubMed  CAS  Google Scholar 

  33. Kurer MH, Khoker MA, Dandona P (1992) Human osteoblast stimulation by sera from paraplegic patients with heterotopic ossification. Paraplegia 30:165–168

    PubMed  CAS  Google Scholar 

  34. Lal S, Hamilton BB, Heinemann A et al (1989) Risk factors for heterotopic ossifications in spinal cord injury. Arch Phys Med Rehabil 70:387–390

    PubMed  CAS  Google Scholar 

  35. Maier D, Brandner H, Bühren V (1998) Ultrasound screening examination in early spinal cord injury for the diagnosis of heterotopic ossifications. In: DRV Schriften (10) 6th European Congress on Research in Rehabilitation. 336 (abstr)

    Google Scholar 

  36. Maier D (2005) Heterotopic ossification spinal cord injury. Management through early diagnosis and therapy. Orthopade 34:120,122-127

    Article  PubMed  CAS  Google Scholar 

  37. Mc Auliffe JA, Wolfson AH (1997) Early excision of heterotopic ossification about the elbow followed by radiotherapy. J Bone Surg Am 79:749–755

    CAS  Google Scholar 

  38. Meiners T, Abel R, Böhm V et al (1997) Resection of heterotopic ossification of the hip in spinal cord injured patients. Spinal Cord 35:443–445

    Article  PubMed  CAS  Google Scholar 

  39. Orzel JA, Rudd TG (1985) Heterotopic bone formation: Clinical, laboratory and imaging correlation. J Nucl Med 26:125–132

    PubMed  CAS  Google Scholar 

  40. Park YK, Huang GS, Taylor JA et al (1993) Patterns of vertebral ossification and pelvic abnormalities in paralysis: a study of 200 patients. Radiology 188:561–565

    PubMed  CAS  Google Scholar 

  41. Pistarini C, Carlevati S, Contardi A et al (1995) Use of ultrasonography methods in the diagnosis of neurogenic paraosteoarthropathy in spinal cord injury. Recent Prog Med 86:483–488

    CAS  Google Scholar 

  42. Sautter-Bihl ML, Liebermeister E, Heinze HG et al (1995) Strahlentherapie heterotoper Ossifikationen bei Querschnittsgelähmten. Strahlenther Onkol 171:454–459

    PubMed  CAS  Google Scholar 

  43. Sautter-Bihl ML, Liebermeister E, Nanassy A (2000) Radiotherapy as a local treatment option for heterotopic ossifications in patients with spinal cord injury. Spinal Cord 38:33–36

    Article  PubMed  CAS  Google Scholar 

  44. Sautter-Bihl ML, Hültenschmidt B, Liebermeister E et al (2001) Fractionated and single-dose radiotherapy for heterotopic bone formation in patients with spinal cord injury. A phase-I/II study. Strahlenther Onkol 177:200–205

    Article  PubMed  CAS  Google Scholar 

  45. Schaeffer MA, Sosner J (1995) Heterotopic ossification: Treatment of established bone with radiation therapy. Arch Phys Med Rehabil 76:284–286

    Article  PubMed  CAS  Google Scholar 

  46. Seegenschmiedt MH, Martus P, Goldmann AR et al (1994) Preoperative versus postoperative radiotherapy for prevention of heterotopic ossification (HO): First results of a randomized trial in high risk patients. Int J Radiat Oncol Biol Phys 30:63–73

    PubMed  CAS  Google Scholar 

  47. Snoecx M, De Muynck M, Van Laere M (1995) Association between muscle trauma and heterotopic ossification in spinal cord injured patients: reflections on their causal relationship and the diagnostic value of ultrasonography. Paraplegia 33:464–468

    PubMed  CAS  Google Scholar 

  48. Stover SM, Niemann KMW, Tuloss JR (1991) Experience with surgical resection of heterotopic bone in spinal cord injury patients. Clin Orthop 263:71–77

    PubMed  Google Scholar 

  49. Subbarao JV, Garrison SJ (1999) Heterotopic ossification: diagnosis and management, current concepts and controversies. Spinal Cord 22:273–283

    CAS  Google Scholar 

  50. Sugarman B (1985) Medical complications of spinal cord injury. Q J Med 54:3–18

    PubMed  CAS  Google Scholar 

  51. Sylvester JE, Greenberg P, Selch MT et al (1988) The use of postoperative irradiation for the prevention of heterotopic bone formation after total hip replacement. Int J Radiat Oncol Biol Phys 14:471–476

    PubMed  CAS  Google Scholar 

  52. Wharton GW, Morgan TH (1970) Ankylosis in the paralyzed patient J Bone Surg 521:105–112

    Google Scholar 

  53. Wharton GW (1975) Heterotopic ossification. Clin Orthop 112:142–149

    PubMed  Google Scholar 

  54. Wittenberg RH, Peschle U, Boetel U (1992) Heterotopic ossification after spinal cord injury. Epidemiology and risk factors. J.Bone Surg (BR) 74:215–218

    CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Radiotherapy, Community Hospital Karlsruhe, Moltkestrasse 90, 76133, Karlsruhe, Germany

    Marie-Luise Sautter-Bihl MD (Professor) & Erhard Liebermeister (Attending Physician)

  2. Department of Radiotherapy, Leopold Franzens University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Peter Lukas MD (Professor)

  3. Department for Paraplegics, SRH Klinikum Karlsbad-Langen-steinbach, Guttmannstraße 1, 76307, Karlsbad, Germany

    Andras Nanassy

  4. Department of Spinal Cord and Myelon Injury, BG Unfallklinik Murnau, Prof.-Küntscher-Straße 8, 82418, Murnau, Germany

    Doris Maier MD (Attending Physician)

Authors
  1. Marie-Luise Sautter-Bihl MD
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  2. Peter Lukas MD
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  3. Erhard Liebermeister
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  4. Doris Maier MD
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  5. Andras Nanassy
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Editor information

Editors and Affiliations

  1. Department of Radiation Oncology and Therapeutic Radiology, Alfried-Krupp-Hospital, Alfried-Krupp-Strasse 21, Postfach 10 22 43, 45117, Essen, Germany

    Michael Heinrich Seegenschmiedt MD (Professor) (Professor)

  2. Strahlenklinik Klinikum Duisburg, Zu den Rehwiesen 9, 47055, Duisburg, Germany

    Hans-Bruno Makoski MD (Professor) (Professor)

  3. Department of Radiation Biology, St. Bartolomew’s Medical College, Charterhouse Square, London, EC1M 6BQ, UK

    Klaus-Rüdiger Trott MD (Professor) (Professor)

  4. Hylda Cohn/American Cancer Society, USA

    Luther W. Brady MD (Professor of Clinical Oncology, and Professor, Department of Radiation Oncology Distinguished University Professor) (Professor of Clinical Oncology, and Professor, Department of Radiation Oncology Distinguished University Professor)

  5. College of Medicine, Drexel University, Broad & Vine Sts., Mail Stop 200, Philadelphia, PA, 19102-1192, USA

    Luther W. Brady MD (Professor of Clinical Oncology, and Professor, Department of Radiation Oncology Distinguished University Professor) (Professor of Clinical Oncology, and Professor, Department of Radiation Oncology Distinguished University Professor)

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© 2008 Springer-Verlag Berlin Heidelberg

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Sautter-Bihl, ML., Lukas, P., Liebermeister, E., Maier, D., Nanassy, A. (2008). Heterotopic Ossifications after Head and Spinal Cord Injuries (HSCI). In: Seegenschmiedt, M.H., Makoski, HB., Trott, KR., Brady, L.W. (eds) Radiotherapy for Non-Malignant Disorders. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68943-0_20

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  • DOI: https://doi.org/10.1007/978-3-540-68943-0_20

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-62550-6

  • Online ISBN: 978-3-540-68943-0

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