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European Journal of Trauma and Emergency Surgery

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01-12-2014 | Original Article

Autonomic dysreflexia: a possible trigger for the development of heterotopic ossifications after traumatic spinal cord injury?

A clinical longitudinal study

Authors: C. Putz, L. Helbig, H. J. Gerner, M. Zimmermann-Stenzel, M. Akbar

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2014

Abstract

Purpose

The aim of this study was to investigate the influence of the initial American Spinal Injury Association Impairment Scale (AIS) category and the conversion rate in acute traumatic tetraplegic patients on the development of heterotopic ossifications (HO). The second objective was to prove the hypothesis that tetraplegic patients with autonomic dysreflexia (AD) develop HO more often than patients without AD.

Methods

A retrospective analysis from 2002 to 2009 of 330 patients with spinal cord injuries was performed and led to the inclusion of 77 traumatic tetraplegic patients. Clinical data was reviewed to determine the appearance of HO (n = 8) and its possible coincidence with AD during urodynamics. Spearman’s correlation coefficient was calculated to test the relationship between HO and initial AIS category or the change in AIS category within 6 weeks. A matched pair (age, neurological level of injury) analysis of two samples (n = 8 with/without appearance of HO; total n = 16) was performed.

Results

The appearance of HO was significantly correlated with an initial AIS A compared to incomplete tetraplegia at baseline (p < 0.017). The conversion of AIS A into incomplete tetraplegia was highly correlated with the incidence of HO (p < 0.003). AD showed a positive correlation with HO (r = 0.97, p = 0.001).

Conclusions

An initial AIS A that converts early into an incomplete tetraplegia constitutes a risk factor for the development of HO. Additionally, AD constitutes an important trigger in the development of HO in acute traumatic tetraplegic patients.

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Title: Autonomic dysreflexia: a possible trigger for the development of heterotopic ossifications after traumatic spinal cord injury?
A clinical longitudinal study
Authors: C. Putz
L. Helbig
H. J. Gerner
M. Zimmermann-Stenzel
M. Akbar
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 6/2014
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-013-0353-8

At a glance: The STEP trials

Springer Medicine

Autonomic dysreflexia: a possible trigger for the development of heterotopic ossifications after traumatic spinal cord injury?

A clinical longitudinal study

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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