Schincariol Cindy Yukie Nakano, Echauri Eduardo Martin Insfrán, Silvestre Orcizo Francisco, Cliquet Alberto
Universidade Estadual de Campinas, Departamento de Ortopedia, Reumatologia e Traumatologia, Campinas, SP, Brazil.
Acta Ortop Bras. 2023 Jul 17;31(3):e267451. doi: 10.1590/1413-785220233103e267451. eCollection 2023.
Trauma configures the main cause of spinal cord injuries. Patients with traumatic spinal cord injury often develop severe and debilitating outcomes that require multidisciplinary care to adapt patients to their new reality. Heterotopic ossification (HO) is one of the frequent comorbidities in these patients but it still lacks well-established treatments or a gold standard one. Thus, this systematic review aimed to search the current literature for HO treatment and prevention. This study was conducted following PRISMA recommendations (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) and searches were conducted in three databases (PubMed, Embase, and Web of Science). A total of 193 articles were found in an initial search. After screening following the established criteria, eight articles were included in this review; of these, two reported prevention and the others, treatments. Based on data analysis, the use of non-steroidal anti-inflammatory drugs in the acute post-traumatic period proved to be the best method of prevention. In cases of mature HO or accompanied by ankylosis, surgical resection proved to be the most effective treatment despite the high rate of postoperative infections.
创伤是脊髓损伤的主要原因。创伤性脊髓损伤患者常常会出现严重且使人衰弱的后果，这需要多学科护理来帮助患者适应新的现实状况。异位骨化（HO）是这些患者常见的合并症之一，但目前仍缺乏成熟的治疗方法或金标准治疗方案。因此，本系统评价旨在检索当前关于HO治疗与预防的文献。本研究按照PRISMA（系统评价与Meta分析的首选报告项目）的建议进行，在三个数据库（PubMed、Embase和Web of Science）中进行了检索。初步检索共找到193篇文章。按照既定标准筛选后，本评价纳入了8篇文章；其中2篇报道了预防措施，其余的报道了治疗方法。基于数据分析，在创伤后急性期使用非甾体类抗炎药被证明是最佳预防方法。对于成熟的HO或伴有关节强硬的情况，尽管术后感染率较高，但手术切除被证明是最有效的治疗方法。
