title: Heterotopic ossification after central nervous system trauma: A current review.
abstract: Neurogenic heterotopic ossification (NHO) is a disorder of aberrant bone formation affecting one in five patients sustaining a spinal cord injury or traumatic brain injury. Ectopic bone forms around joints in characteristic patterns, causing pain and limiting movement especially around the hip and elbow. Clinical sequelae of neurogenic heterotopic ossification include urinary tract infection, pressure injuries, pneumonia and poor hygiene, making early diagnosis and treatment clinically compelling. However, diagnosis remains difficult with more investigation needed. Our pathophysiological understanding stems from mechanisms of basic bone formation enhanced by evidence of systemic influences from circulating humor factors and perhaps neurological ones. This increasing understanding guides our implementation of current prophylaxis and treatment including the use of non-steroidal anti-inflammatory drugs, bisphosphonates, radiation therapy and surgery and, importantly, should direct future, more effective ones.
authors.affiliation: Hospital of the University of Pennsylvania, Department of Orthopaedic Surgery, 3400 Spruce Street, Philadelphia, Pennsylvania 19104, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Sullivan
authors.forename: S J
authors.initials: SJ
authors.lastname: Torres
authors.forename: S
authors.initials: S
authors.lastname: Mehta
authors.forename: J
authors.initials: J
authors.lastname: Ahn
keywords: Heterotopic ossification; Neurogenic; Neurohumoral; Osteogenesis; Prophylaxis; Spinal cord injury; Traumatic brain injury