Stover S L, Hataway C J, Zeiger H E
Arch Phys Med Rehabil. 1975 May;56(5):199-204.
Therapy programs during the development of heterotopic ossification in spinal cord injury range widely from complete rest to aggressive exercise programs. The literature is confusing by its multiplicity of recommendations because the basic etiology and pathophysiology are unknown and because some basic differences exist between traumatic myositis ossificans and heterotopic ossification associated with severe neurological impairments. Prospective heterotopic ossification roentgenographic (x-ray) surveys of the hips, knees, shoulders, and elbows were made on 250 consecutive spinal cord-injured patients. Those who had x-ray evidence of early or immature heterotopic ossification or who developed early clinical signs of possible heterotopic ossification were treated with an aggressive program of passive progressive range of motion exercises. Several patients who developed bilateral heterotopic ossification had one side used as their own control. Follow-up x-ray studies and range of motion evaluation suggest that an aggressive range of motion exercise program is indicated for patients who are developing or have heterotopic ossification. There is no evidence that exercise increases inflammation with subsequent ossification, and it frequently causes a pseudarthrosis, permitting adequate functional range of motion.
脊髓损伤后异位骨化发展过程中的治疗方案范围广泛，从完全休息到积极的锻炼计划。由于基本病因和病理生理学尚不清楚，且创伤性骨化性肌炎与伴有严重神经损伤的异位骨化之间存在一些基本差异，文献中的众多建议令人困惑。对250例连续脊髓损伤患者的髋、膝、肩和肘部进行了前瞻性异位骨化X线检查。那些有早期或未成熟异位骨化X线证据或出现可能异位骨化早期临床体征的患者，接受了积极的被动渐进性活动范围锻炼计划治疗。几名发生双侧异位骨化的患者将一侧作为自身对照。随访X线研究和活动范围评估表明，对于正在发生或已发生异位骨化的患者，应采用积极的活动范围锻炼计划。没有证据表明锻炼会增加炎症并随后导致骨化，而且它经常会导致假关节形成，从而允许有足够的功能活动范围。
