Taravati Sahil, Cinar Ece, Akkoc Yesim
Department of Physical Medicine and Rehabilitation, Ege University School of Medicine, Izmir, Turkey.
Spinal Cord Ser Cases. 2017 Jun 8;3:17032. doi: 10.1038/scsandc.2017.32. eCollection 2017.
Heterotopic ossification (HO) is defined as ectopic bone formation around peripheral joints and in soft tissues. HO is a common complication of diseases of the central nervous system, such as spinal cord injury (SCI) and traumatic brain injury. HO is seen in up to 50% of patients with SCI and typically occurs in the first 12 weeks after onset of injury. Although no treatment method is proven to be curative, nonsteroidal anti-inflammatory drugs, irradiation of the involved body part and bisphosphonates are commonly used in the management of HO.
Here we present a 27-year-old male patient with a T10 ASIA Impairment Scale (AIS) A SCI, who developed hyperphosphatemia as a complication of bisphosphonate therapy initiated for the treatment of HO during the 6th post-operative week. After cessation of etidronate use, phosphate levels gradually returned to normal over 2 weeks.
Hyperphosphatemia is a rare complication of etidronate use. It is speculated to result from increased renal tubular phosphate reabsorption and is usually asymptomatic. Although mostly asymptomatic, this complication must be kept in mind while administering etidronate to SCI patients and blood phosphate levels should be monitored in the early weeks of treatment.
异位骨化（HO）被定义为外周关节周围和软组织中的异位骨形成。HO是中枢神经系统疾病的常见并发症，如脊髓损伤（SCI）和创伤性脑损伤。高达50%的SCI患者会出现HO，通常发生在损伤发作后的前12周内。尽管尚无被证明具有治愈性的治疗方法，但非甾体类抗炎药、对受累身体部位进行放射治疗以及双膦酸盐常用于HO的管理。
在此，我们报告一名27岁男性患者，患有T10级美国脊髓损伤协会（ASIA）损伤量表（AIS）A级的SCI，在术后第6周因治疗HO开始使用双膦酸盐治疗而出现高磷血症并发症。停用依替膦酸后，磷水平在2周内逐渐恢复正常。
高磷血症是使用依替膦酸罕见的并发症。推测其是由肾小管对磷的重吸收增加所致，通常无症状。尽管大多无症状，但在给SCI患者使用依替膦酸时必须牢记这一并发症，且在治疗的最初几周应监测血磷水平。
