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  4. Extracorporeal shock wave therapy to treat neurogenic heterotopic ossification in a patient with spinal cord injury: A case report

Extracorporeal shock wave therapy to treat neurogenic heterotopic ossification in a patient with spinal cord injury: A case report

The Journal of Spinal Cord Medicine, 2021 · DOI: 10.1080/10790268.2019.1632597 · Published: July 1, 2021

Spinal Cord InjuryOrthopedicsMusculoskeletal Medicine

Simple Explanation

This case report explores the use of Extracorporeal Shock Wave Therapy (ESWT) to treat Neurogenic Heterotopic Ossification (NHO) in a patient with a spinal cord injury. NHO is a condition where bone forms in soft tissues, causing pain and limiting movement, especially in people with spinal cord injuries. The study found that ESWT may be a viable alternative to other treatments for NHO in individuals with SCI, as it helped reduce pain and improve daily activities.

Study Duration
7 weeks
Participants
A 55-year-old male with cervical SCI
Evidence Level
Level 4: Single case report

Key Findings

  • 1
    ESWT treatment reduced the patient's pain from a VAS score of 7-8 to 3 after 7 weeks of treatment.
  • 2
    The patient's wheelchair sitting time increased after ESWT treatment.
  • 3
    There was no significant change in the size of the NHO as measured by radiograph after ESWT treatment.

Research Summary

This case report describes the effect of ESWT on NHO in a person with SCI who had been previously treated with non-steroidal anti-inflammatory drugs (NSAIDs), bisphosphonates, and physical modalities. The report indicates that ESWT can be used to treat NHO, reducing pain and improving activities of daily living (ADLs). The authors suggest that ESWT could be a safe, non-invasive, and effective method for treating NHO in individuals with SCI, although further studies with larger groups are recommended.

Practical Implications

Pain Management

ESWT can be considered as an alternative or complementary treatment option for pain reduction in SCI patients with NHO.

Improved ADLs

ESWT may improve the ability of SCI patients with NHO to perform daily activities, such as wheelchair sitting and transfers.

Non-invasive Treatment

ESWT offers a non-invasive approach compared to surgical options for treating NHO, reducing the risks associated with surgery.

Study Limitations

  • 1
    Single case report limits generalizability.
  • 2
    No control group for comparison.
  • 3
    Lack of long-term follow-up data beyond 6 months.

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