title: Beliefs relating to recurrence of heterotopic ossification following excision in patients with spinal cord injury: a review.
abstract: METHODS
  Review of the literature.
  
  
  OBJECTIVE
  It is widely believed that the timing of surgery and the size of the initial Neurological Heterotopic Ossification (NHO) affect the recurrence risk of NHO after SCI. A large number of studies were published in the 80s and the 90s, mostly of poor quality despite the fact that they were carried out by experienced surgical teams. The aim of this study was to suggest recommendations relating to the timing of excision of heterotopic ossification after SCI following the analysis of a recent review of the literature.
  
  
  METHODS
  France.
  
  
  METHODS
  A systematic literature search was performed in the PubMed Embase from January 2002 until June 2014 using the MESH headings 'spinal cord injury', 'paraplegia', 'heterotopic ossification' and 'surgery'. Results were compared with results from epidemiological studies based on the BANKHO database (patients who underwent surgery for troublesome HO after central neurological system (CNS) lesions in our center (357 patients, 539 surgeries)).
  
  
  RESULTS
  Few studies were found in the literature, results were sometimes contradictory and practices heterogeneous. Results from the BANKHO database showed that troublesome recurrence of NHO was not associated with 'early' surgery (before 6 months), and no association was found between recurrence and the size of the NHO around the joint (Brooker status).
  
  
  CONCLUSIONS
  We suggest that surgical excision of the NHO should be carried out when it begins to be troublesome, as soon as comorbid factors are under control and the HO is sufficiently constituted for excision.
authors: 1] Department of Physical Medicine and Rehabilitation, Hôpital Raymond Poincaré, APHP, CIC-IT 1429, Garches, France [2] Université Versailles Saint Quentin en Yvelines, "End:icap" U1179 INSERM, UFR des Sciences de la Santé-Simone Veil, Montigny le Bretonneux, France [3] Service de Médecine Physique et de Réadaptation, Service de Santé des Armées, Hôpital d'Instruction des Armées Percy, Clamart, France.
authors: F
authors: F
authors: Genêt
authors: 1] Department of Physical Medicine and Rehabilitation, Hôpital Raymond Poincaré, APHP, CIC-IT 1429, Garches, France [2] University of Versailles Saint Quentin en Yvelines, HANDI-ReSP (EA4047), UFR des Sciences de la Santé-Simone Veil, Montigny le Bretonneux, France.
authors: A
authors: A
authors: Ruet
authors: Department of Physical Medicine and Rehabilitation, Hôpital Raymond Poincaré, APHP, CIC-IT 1429, Garches, France.
authors: W
authors: W
authors: Almangour
authors: Service de Chirurgie Orthopédique, Hôpital Raymond Poincaré, APHP, Garches, France.
authors: L
authors: L
authors: Gatin
authors: 1] Université Versailles Saint Quentin en Yvelines, "End:icap" U1179 INSERM, UFR des Sciences de la Santé-Simone Veil, Montigny le Bretonneux, France [2] Service de Chirurgie Orthopédique, Hôpital Raymond Poincaré, APHP, Garches, France.
authors: P
authors: P
authors: Denormandie
authors: 1] Department of Physical Medicine and Rehabilitation, Hôpital Raymond Poincaré, APHP, CIC-IT 1429, Garches, France [2] University of Versailles Saint Quentin en Yvelines, HANDI-ReSP (EA4047), UFR des Sciences de la Santé-Simone Veil, Montigny le Bretonneux, France.
authors: A
authors: A
authors: Schnitzler
mesh_terms: D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D006801:Humans; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D009999:Ossification, Heterotopic / Q000209:etiology*; D011183:Postoperative Complications / Q000503:physiopathology*; D012008:Recurrence; D013119:Spinal Cord Injuries / Q000601:surgery*; D013997:Time Factors