Troublesome heterotopic ossification after central nervous system damage: a survey of 570 surgeries.
Troublesome heterotopic ossification after central nervous system damage: a survey of 570 surgeries.
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DOI：
10.1371/journal.pone.0016632
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发表时间：
2011-01-31
期刊：
影响因子：
3.7
通讯作者：
Denormandie P
中科院分区：
文献类型：
--
作者：
Genêt F;Jourdan C;Schnitzler A;Lautridou C;Guillemot D;Judet T;Poiraudeau S;Denormandie P
异位骨化（HO）是中枢神经系统（CNS）损伤后常见的并发症，但很少有人研究。我们的目的是首次在大样本中调查HO的特征，以及HO在手术时间方面的早期复发率。我们回顾性分析了1993年5月至2009年11月在我们机构接受手术的患者的匿名前瞻性调查数据，这些患者与获得性神经系统疾病相关的麻烦HO有关。记录人口统计学和HO特征以及神经系统病因学。对于357例连续患者，我们收集了539例首次HO手术的数据（129例手术在多个部位进行）。随访期间，31例患者出现复发，需要再次手术（5.8% [31/539]; 95%置信区间[CI]：3.8%-7.8%; 27例患者）。大多数需要手术的HO发生在创伤性脑损伤（199例患者[55.7%]）后，然后是脊髓损伤（86例[24.0%]）、卒中（42例[11.8%]）和脑缺氧（30例[8.6%]）。髋关节是HO的原发部位（328例[60.9%]），其次手肘关节（115例[21.3%]）、膝关节（77例[14.3%]）和肩关节（19例[3.5%]）。对于所有患者，181例手术在CNS损伤后的第一年内进行，没有HO复发。复发与病因（p = 0.46）、性别（p = 1.00）、CNS损伤时的年龄（p = 0.2）、多部位定位（p = 0.34）或手术延迟（p = 0.7）无关。 在中枢神经系统损伤的患者中，麻烦的HO和复发最常发生在创伤性脑损伤后，并且经常出现在髋关节和肘关节。早期手术不是HO复发的因素。
Heterotopic ossification (HO) is a frequent complication after central nervous system (CNS) damage but has seldom been studied. We aimed to investigate features of HO for the first time in a large sample and the rate of early recurrence of HO in terms of the time of surgery. We retrospectively analyzed data from an anonymous prospective survey of patients undergoing surgery between May 1993 and November 2009 in our institution for troublesome HO related to acquired neurological disease. Demographic and HO characteristics and neurological etiologies were recorded. For 357 consecutive patients, we collected data on 539 first surgeries for HO (129 surgeries for multiple sites). During the follow-up, recurrences requiring another surgery appeared in 31 cases (5.8% [31/539]; 95% confidence interval [CI]: 3.8%–7.8%; 27 patients). Most HO requiring surgery occurred after traumatic brain injury (199 patients [55.7%]), then spinal cord injury (86 [24.0%]), stroke (42 [11.8%]) and cerebral anoxia (30 [8.6%]). The hip was the primary site of HO (328 [60.9%]), then the elbow (115 [21.3%]), knee (77 [14.3%]) and shoulder (19 [3.5%]). For all patients, 181 of the surgeries were performed within the first year after the CNS damage, without recurrence of HO. Recurrence was not associated with etiology (p = 0.46), sex (p = 1.00), age at CNS damage (p = 0.2), multisite localization (p = 0.34), or delay to surgery (p = 0.7). In patients with CNS damage, troublesome HO and recurrence occurs most frequently after traumatic brain injury and appears frequently in the hip and elbow. Early surgery for HO is not a factor of recurrence.
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DOI：
10.2106/00004623-197355080-00006
发表时间：
1973-01-01
影响因子：
5.3
作者：
BROOKER, AF;BOWERMAN, JW;RILEY, LH
通讯作者：
RILEY, LH
影响因子：
4.7
作者：
da Paz, Aloysio Campos;Carod Artal, Francisco J.;Kalil, Ricardo K.
通讯作者：
Kalil, Ricardo K.
DOI：
10.1038/sc.1994.13
发表时间：
1994-02-01
期刊：
PARAPLEGIA
影响因子：
--
作者：
DITUNNO, JF;YOUNG, W;CREASEY, G
通讯作者：
CREASEY, G
影响因子：
1.9
作者：
Denys, P;Azouvi, P;Bussel, B
通讯作者：
Bussel, B
影响因子：
1.9
作者：
Beingessner, DM;Patterson, SD;King, GJW
通讯作者：
King, GJW