title: Chiropractic care of a patient with neurogenic heterotopic ossification of the anterior longitudinal ligament after traumatic brain injury: a case report.
abstract: OBJECTIVE
  The purpose of this case report is to describe the use of chiropractic care for a patient with neurogenic heterotopic ossification of the anterior longitudinal ligament in the cervical spine and soft tissues of the right hip after a traumatic brain injury and right femur fracture.
  
  
  METHODS
  A 25-year-old military officer was referred to a hospital-based chiropractic clinic with complaints of pain and stiffness of the neck and back along with reduced respiratory excursions that began several months after a motor vehicle accident in which he had a traumatic brain injury. The patient had a fractured right femur from the accident, which had since been treated surgically, but had complications of heterotopic ossification in the soft tissues of the hip. His overall pain level was 3 of 10 on a verbal pain scale during use of oxycodone HCL/acetaminophen. Chest excursion was initially measured at .5 cm.
  
  
  RESULTS
  With the intent to restore respiratory chest motion and to reduce the patient's back and neck pain, the patient was placed on a program of chiropractic and myofascial manipulation, exercise therapy, and respiratory therapy. After a year of care, the patient rated overall pain at 3 of 10 verbal pain scale level but was no longer taking medications for pain and an increase in respiratory chest excursions measured at 3.5 cm.
  
  
  CONCLUSIONS
  This case demonstrated that chiropractic treatment provided benefit to a patient with heterotopic ossification concurrent with musculoskeletal pain.
authors.affiliation: Chiropractor, Physical Medicine and Rehabilitation Department, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: William E
authors.initials: WE
authors.lastname: Morgan
authors.affiliation: Chiropractor, Physical Medicine and Rehabilitation Department, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: Clare P
authors.initials: CP
authors.lastname: Morgan
keywords: Brain injuries; Chiropractic; Heterotopic; Manipulation; Military personnel; Ossification; Spinal