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  4. A Novel Surgical Technique for the Management of Large-Volume Neurogenic Heterotopic Ossification Following a Spinal Cord Injury: The Sashimi Technique

A Novel Surgical Technique for the Management of Large-Volume Neurogenic Heterotopic Ossification Following a Spinal Cord Injury: The Sashimi Technique

Cureus, 2024 · DOI: 10.7759/cureus.60966 · Published: May 23, 2024

SurgeryOrthopedics

Simple Explanation

This paper introduces the 'sashimi technique,' a new surgical method for removing abnormal bone growth (heterotopic ossification or HO) after spinal cord injuries. The technique uses a curved chisel to precisely remove the extra bone, aiming to preserve healthy tissue and improve patient mobility. The goal is to minimize bone removal while improving the range of motion and quality of life for patients.

Study Duration
10-month postoperative follow-up for Case 1, 6 months for Case 2
Participants
Two patients with spinal cord injuries and heterotopic ossification of the hip
Evidence Level
Case Series

Key Findings

  • 1
    The 'sashimi technique' using a curved chisel allows for precise resection of heterotopic ossification while preserving surrounding healthy bone and neurovascular structures.
  • 2
    Both patients in the case series experienced improved hip flexion and mobility after the surgery using this technique.
  • 3
    Postoperative radiotherapy and pharmacological treatment were used to prevent recurrence of heterotopic ossification.

Research Summary

This case series introduces a novel surgical technique, the 'sashimi technique,' for managing heterotopic ossification (HO) following spinal cord injuries. The technique utilizes a curved chisel to precisely resect ectopic bone, minimizing damage to surrounding healthy tissue and neurovascular structures. The study reports improved patient mobility and functional outcomes in two cases, with postoperative radiotherapy and pharmacological treatment aimed at preventing HO recurrence.

Practical Implications

Improved Surgical Precision

The curved chisel in the sashimi technique allows for more targeted tissue removal, enhancing surgical precision and minimizing damage to surrounding structures.

Enhanced Postoperative Outcomes

Preserving healthy tissue during resection leads to faster healing, reduced pain, and better long-term joint mobility and function.

Recurrence Prevention

Combining the sashimi technique with postoperative radiotherapy and pharmacological treatment can effectively reduce the recurrence of heterotopic ossification.

Study Limitations

  • 1
    Limited to a case series of two patients
  • 2
    Lack of long-term follow-up data
  • 3
    Absence of a control group for comparison

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