Extracorporeal shock wave therapy to treat neurogenic heterotopic ossification in a patient with spinal cord injury: A case report.

Objective

To evaluate the efficacy and safety of treatment for neurogenic heterotopic ossification (NHO) using extracorporeal shock wave therapy (ESWT) in persons with spinal cord injury (SCI).

Design

Single case report.

Setting

Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center.

Participants

A 55-year-old male with cervical SCI, who developed painful NHO around the right hip joint.Interventions: Ultrasound-guided ESWT that used 4,000 shocks at the rate of 3 Hz and the energy flux density between 0.056 and 0.068 mJ/mm2 was applied to the NHO region a total of 7 times, weekly.Outcome Measures: We assessed the treatment outcomes using a visual analog scale (VAS) score, wheelchair sitting time and size of NHO.Result: After 7 weeks of ESWT treatment, his pain reduced from a VAS score of 7-8 to 3 and his wheelchair sitting time increased. However, there was no significant change of size of NHO.

Conclusion

The application of ESWT could be a possible alternative to other treatments for NHO in persons with SCI.Clinical Trial Registry Number: 2019-03-003.