Reznik J E, Biros E, Lamont A C, Sacher Y, Kibrik O, Milanese S, Gordon S, Galea M P
a College of Healthcare Science and Division of Tropical Health and Medicine.
b Queensland Research Centre for Peripheral Vascular Disease.
Brain Inj. 2017;31(4):526-532. doi: 10.1080/02699052.2017.1283059. Epub 2017 Mar 24.
Neurogenic heterotopic ossification (NHO) is a complication of a neurological injury following traumatic brain injury (TBI) and may be present around major synovial joints. It is often accompanied by severe pain, which may lead to limitation in activities of daily living. Currently, a common intervention for NHO is surgery, which has been reported to carry many additional risks. This study was designed to assess the effect of extracorporeal shock wave therapy (ESWT) on pain in patients with TBI with chronic NHO.
A series of single-case studies (n = 11) was undertaken with patients who had TBI and chronic NHO at the hip or knee. Each patient received four applications of high-energy EWST delivered to the affected joint over 8 weeks. Two-weekly follow-up assessments were carried out, and final assessments were made 3 and 6 months post-intervention. Pain was measured using the Faces Rating Scale, and X-rays were taken at baseline and 6-months post-intervention to physiologically measure the size of the NHO.
The application of high-energy ESWT was associated with significant overall reduction of pain in patients with TBI and NHO (Tau-0.412, 95% confidence interval -0.672 to -0.159, p = 0.002).
ESWT is a novel non-invasive intervention for reducing pain resulting from NHO in patients with TBI.
神经源性异位骨化（NHO）是创伤性脑损伤（TBI）后神经损伤的一种并发症，可能出现在主要滑膜关节周围。它常伴有严重疼痛，这可能导致日常生活活动受限。目前，NHO的常见干预措施是手术，但据报道手术存在许多额外风险。本研究旨在评估体外冲击波疗法（ESWT）对慢性NHO的TBI患者疼痛的影响。
对11例患有TBI且髋部或膝部存在慢性NHO的患者进行了一系列单病例研究。每位患者在8周内接受4次高能EWST治疗，治疗部位为受影响的关节。每两周进行一次随访评估，并在干预后3个月和6个月进行最终评估。使用面部表情评分量表测量疼痛程度，并在基线和干预后6个月拍摄X线片，以生理方式测量NHO的大小。
高能ESWT的应用与TBI和NHO患者的疼痛总体显著减轻相关（Tau=-0.412，95%置信区间为-0.672至-0.159，p=0.002）。
ESWT是一种新型非侵入性干预措施，可减轻TBI患者因NHO引起的疼痛。
