Long-term radial extracorporeal shock wave therapy for neurogenic heterotopic ossification after spinal cord injury: A case report

The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2020.1760507 · Published: May 1, 2022

Spinal Cord Injury Rehabilitation Musculoskeletal Medicine

Simple Explanation

Heterotopic ossification (HO) is when bone grows in soft tissues where it shouldn't, causing pain and limiting movement. Neurogenic HO (NHO) happens after injuries to the central nervous system like spinal cord injury. This case report explores using radial extracorporeal shock wave therapy (RSWT) to treat NHO in a woman with spinal cord injury. RSWT involves applying pressure pulses to the affected area. The patient received RSWT for almost a year, and the study tracked changes in the HO lesion size, joint movement, pain levels, and a marker of bone formation in the blood.

Study Duration

1 Year

Participants

1 patient with neurogenic heterotopic ossification

Evidence Level

Level 4; Case Report

Key Findings

1
Long-term RSWT was associated with a gradual decrease in the size of the heterotopic ossification lesion.
2
The patient experienced an increase in joint range of motion during the treatment period.
3
Pain was mitigated as suggested by the reduction of VAS score from 8 to 1 after 1.5 months of the treatment which was maintained for another five months.

Research Summary

This case report describes the application of long-term RSWT in a patient with NHO secondary to SCI. The patient demonstrated improvement in pain, ROM, and a reduction in lesion size. RSWT may improve microcirculation and metabolic activity, leading to pain reduction and neovascularization. The findings suggest that long-term RSWT could be a promising therapeutic alternative for NHO, although further research is needed.

Practical Implications

Clinical Practice

Long-term RSWT can be considered as a potential treatment option for NHO in patients with SCI.

Future Research

Further research is needed to determine the optimal parameters and long-term effects of RSWT for NHO.

Patient Management

Regular monitoring of pain, ROM, and lesion size is important during RSWT treatment for NHO.

Study Limitations

1
The study is limited to a single case report.
2
Serum C-reactive protein levels were not measured.
3
The RSWT parameters were based on prior cases and clinical experience, lacking strong evidence.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury