Incidence and characteristics of heterotopic ossification after spinal cord injury: a single institution study in India

Abstract

Study design: This was a single-centre, retrospective, descriptive, hospital-based study in persons with spinal cord injuries (SCI) patients. Objectives: To study the incidence and characteristics of heterotopic ossification (HO) after SCI. Setting: The in-patient services of the Department of Physical Medicine and Rehabilitation of a tertiary care institute in India between January 2001 and December 2017. Methods: Medical records of all consecutive patients with diagnosis of SCI in the age group of 15–60 years were reviewed for presence of HO (diagnosed by clinical signs, laboratory investigations (ALP, ESR and X-rays)) and characteristics of HO. R-Ver 3.4.2 was used for analysis and correlations. Results were considered significant at P < 0.05. Results: A total of 303 patients satisfied inclusion criteria. Nineteen individuals (6.3%) had developed HO. Seven (37%) were diagnosed within 3 months of SCI. Twelve (63%) patients developed unilateral HO. The most common site for HO was hip joint (73%). A significant association was found between the presence of a pressure ulcer and development of HO (P = 0.01). Conclusions: The incidence of HO was 6.3% in our institution and the hip joint is the most common site. Due to the presence of limited treatment options it is important to diagnose HO early in patients with SCI based on clinical features and later confirmed with laboratory tests and imaging.