HETEROTOPIC OSSIFICATION AFTER SPINAL CORD INJURY: PREVENTION AND TREATMENT - A SISTEMATIC REVIEW.

IF 0.5 4区医学 Q4 ORTHOPEDICS

Acta Ortopedica Brasileira Pub Date : 2023-01-01 DOI:10.1590/1413-785220233103e267451

Cindy Yukie Nakano Schincariol, Eduardo Martin Insfrán Echauri, Orcizo Francisco Silvestre, Alberto Cliquet

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Abstract

Trauma configures the main cause of spinal cord injuries. Patients with traumatic spinal cord injury often develop severe and debilitating outcomes that require multidisciplinary care to adapt patients to their new reality. Heterotopic ossification (HO) is one of the frequent comorbidities in these patients but it still lacks well-established treatments or a gold standard one. Thus, this systematic review aimed to search the current literature for HO treatment and prevention. This study was conducted following PRISMA recommendations (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) and searches were conducted in three databases (PubMed, Embase, and Web of Science). A total of 193 articles were found in an initial search. After screening following the established criteria, eight articles were included in this review; of these, two reported prevention and the others, treatments. Based on data analysis, the use of non-steroidal anti-inflammatory drugs in the acute post-traumatic period proved to be the best method of prevention. In cases of mature HO or accompanied by ankylosis, surgical resection proved to be the most effective treatment despite the high rate of postoperative infections. Level of Evidence III, Systematic Review.

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脊髓损伤后异位骨化:预防和治疗-系统综述。

创伤是脊髓损伤的主要原因。创伤性脊髓损伤患者往往会出现严重和衰弱的结果，需要多学科的护理，以使患者适应新的现实。异位骨化(HO)是这些患者常见的合并症之一，但仍缺乏完善的治疗方法或金标准。因此，本系统综述旨在检索目前有关HO治疗和预防的文献。本研究遵循PRISMA建议(系统评价和荟萃分析的首选报告项目)进行，并在三个数据库(PubMed, Embase和Web of Science)中进行了搜索。在最初的搜索中，总共发现了193篇文章。在按照既定标准筛选后，本综述纳入了8篇文章;其中，两个报告了预防，其他报告了治疗。数据分析表明，急性创伤后期应用非甾体类抗炎药是最好的预防方法。在成熟的HO或伴有强直的病例中，手术切除被证明是最有效的治疗方法，尽管术后感染率很高。证据水平III，系统评价。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ortopedica Brasileira Orthopedics-

CiteScore

0.90

自引率

14.30%

发文量

审稿时长

25 weeks

期刊介绍： A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.