Evaluation of Serum Osteoblast Mitogenic Activity in Spinal Cord and Head Injury Patients With Acute Heterotopic Ossification

Renfree, Kevin J.; Banovac, K; Hornicek, Francis J.; Lebwohl, Nathan H.; Villanueva, Philip A.; Nedd, Kester

doi:10.1097/00007632-199404000-00002

Cited by 44 publications

(34 citation statements)

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“…However, no signi®cant di erences were seen when patients who developed NHO were compared to other patients and healthy control subjects. Because their ®ndings did not support the existence of a humoral factor that directly stimulates osteoblast proliferation within the ®rst 12 weeks post injury, Renfree et al 26 hypothesized that the rise in mitogenic activity seen in their patients may indirectly play a role in the bone inductive process.…”

Section: Pathophysiologymentioning

confidence: 97%

Neurogenic heterotopic ossification in spinal cord injury

2002

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Neurogenic heterotopic ossi®cation (NHO) is a frequent complication in spinal cord injury (SCI) that is often di cult to treat. This review emphasizes the incidence, risk factors and clinical signs of NHO in SCI patients. Although the exact pathophysiology underlying NHO in neurologic patients is not yet understood, di erent pathogenic mechanisms have been proposed in the literature. A selection of the most important theories will be given and discussed. Moreover the di erent diagnostic, therapeutic, and preventive methods currently used in NHO management after SCI will be reviewed.

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Section: Pathophysiologymentioning

confidence: 97%

Neurogenic heterotopic ossification in spinal cord injury

2002

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“…4 ± 7 Recent experimental studies demonstrated the increase of the serum osteoblast mitogenic activity together with an increased condroblastic and osteoblastic activity as consequence of a decreased tissue oxygenation in spinal cord injury. 8 Furthermore, the elevation of urinary prostaglandins which has an e ect on the formation of lamellar bone, may play a role in the formation of HO. 9 The hypothesis of a dysmetabolic etiology of HO may be also supported by functional and morphological changes of the lymphatic and blood microvasculature of the paretic legs described in patients after spinal cord injury.…”

Section: Introductionmentioning

confidence: 99%

Microvascular changes in the lower extremities of paraplegics with heterotopic ossification

Lotta¹,

Scelsi

2001

Spinal Cord

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Objectives: To investigate the morphological aspects of blood microvasculature of the skin and subcutaneous tissues in subjects with paraplegia with heterotopic ossi®cation (HO). Methods: In two patients with traumatic spinal cord injury and HO, punch biopsies of skin and hypodermic soft tissue in the region of HO near the hip were studied with histological and ultrastructural methods. Results: Alterations of endothelial cell and basement membrane of capillaries and small vessels were observed. Hyperactive endothelium, thickening and reduplication of the basement membrane, changes of the perivascular connective tissues and microcalci®cations in the subcutaneous fat tissue were also seen.Conclusions: This present study indicates microvascular changes in the skin and subcutaneous tissue in the region of HO near the hip of two subjects with paraplegia. In our opinion the described vascular changes may induce hypoxiemic alterations of the soft para-articular tissues leading metabolic changes which may contribute to the development of HO. Therefore, it cannot be concluded whether these changes are directly responsible for HO induction. Spinal Cord (2001) 39, 595 ± 598

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“…[1][2][3][4][5][6][7][8][9][10] In spite of numerous attempts to establish the mechanisms involved whereby severe head or spinal cord injury influences osteogenesis at a distant site, the phenomenon remains poorly understood.…”

Section: Introductionmentioning

confidence: 99%