Use of radiotherapy in immature heterotopic ossification in patients with spinal cord injury

Abstract

The incidence of heterotopic ossification (HO) in adult patients with spinal cord injuries is roughly 20%. HO usually has a benign development, but can reduce the range of joint motion and hinder the rehabilitation process. Few studies have shown the use of radiotherapy in the treatment of HO in patients with spinal cord injuries. The objective of this study is to assess whether immature heterotopic ossification progresses in patients with spinal cord injuries submitted to radiotherapy as the primary treatment. The medical records of patients attending the spinal cord injury clinic of AACD (Associação de Assistência à Criança Deficiente) with immature HO and who were treated exclusively with radiotherapy were selected. This is a historical cohort-type study. Ossification progress was determined by analysis of the range of motion of the affected joint, measurements with a goniometer and radiographic image. Ossification was classified according to the classification proposed by Brooker et al. The study follow-up period was 23.3 months. Fourteen of the 15 studied joints did not worsen clinically, nor did the HO progress. None of the patients had side effects from radiotherapy. We conclude that patients treated early with radiotherapy do not present significant HO development and that radiotherapy is a safe and easy-to-use method.