The treatment of immature heterotopic ossification in spinal cord injury with combination surgery, radiation therapy and NSAID

Heterotopic ossification (HO) is a frequent complication associated with sp inal cord injury. Management of HO consists of a combination of range-of-mo tion, diphosphonates nonsteroidal antiinflammatory agents, radiation therap y, and in some cases, surgical resection. The appropriate timing of surgica l resection has traditionally been based on maturity of the HO. The case pr esented is that of a 33-year-old male with T8 complete paraplegia who devel oped HO about the left hip resulting in impaired sitting. The patient under went successful surgical wedge resection of the HO despite apparent immatur ity of the HO. A comprehensive review of the literature is presented which suggests that early resection of immature HO may not be predictive of a hig her recurrence rate.