Neurogenic heterotopic ossification: A review. Part 2

Abstract

BACKGROUND: Neurogenic heterotopic ossification is characterized by the formation of bone tissue in the soft tissues of the body caused by severe brain or spinal cord injury of various etiologies. In neurogenic heterotopic ossification, the hip joints are most often affected. AIM: To analyze publications on the instrumental diagnosis, surgical and nonsurgical methods of treatment, and prevention of neurogenic heterotopic ossification of the hip joints. MATERIALS AND METHODS: In the second part of our review, we analyzed the literature on modern diagnostics, surgical and conservative methods of treatment, prevention of the formation and recurrence of neurogenic heterotopic ossification of the hip joints. Data were searched in scientific literature databases, namely, PubMed, Google Scholar, Cochrane Library, CrossRef, and eLibrary, without language restrictions. RESULTS: Modern diagnostic methods allow the screening of hip neurogenic heterotopic ossification in patients at high risk of their formation, with further verification of the diagnosis by computed tomography or magnetic resonance imaging. Despite the lack of consensus on the timing of hip neurogenic heterotopic ossification removal at present, surgical treatment is the most effective method, which allows the removal or reduction of the volume of neurogenic heterotopic ossification. Most cases require controlling the pain syndrome and improving the quality of life of the patients. Despite the common etiologic factor (damage to the central nervous system), nonsurgical methods of the prevention and treatment of patients with neurogenic heterotopic ossification of the hip joints have different effectiveness because of spinal cord injury, cerebral trauma, and cerebral palsy. CONCLUSIONS: Randomized controlled trials will help to establish the efficacy of conservative treatment methods to prevent the formation and recurrence of hip joint neurogenic heterotopic ossification, taking into account the cause of central nervous system lesions.