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Heterotopic Ossification and Your Cervical Spine

Heterotopic Ossification (HO) is one of the most common complications following hip arthroscopy. It is estimated that up to 44% of do not receive medication prophylaxis will experience some form of complication following this procedure.*

In cervical spine surgery, namely total cervical disc replacement surgery, this complication is present but not to the same extent. In any regard, I prophylactically treat all of my patient’s undergoing a total cervical disc replacement with a prophylactic dose of medication for a few weeks after their case.

Heterotopic ossification (HO) occurs and forms as a result of some type of trauma (whether controlled trauma = surgery) or (uncontrolled trauma = accidental injury). What occurs with HO is a “deposit” of bone around the soft tissues that surround a joint – that ultimately leads to a “bone-building” or osteogenic response in the surrounding muscles.

This further creates these bone deposits of normal bone in abnormal places and locations. Using medications to help provide prophylaxis to the body and this process = targets this bone deposits. Using a NSAID further alters the target muscle cells and tissues, disrupts the body’s signal of producing these bone deposits, and finally it further modifies the environment where the bone will be deposited by allowing a less conducive environment for these cells to deposit the bone there in the first place.

There are numerous articles on using prophylactic why NSAIDs have become the recommended treatment strategy for HO prevention. Usually using medications like, Indomethicin or Naproxen, can usually help curb the potential for HO deposits.

Of course there are risks associated with using NSAIDs, such as GI upset, kidney side effects, and the risk for bleeding. Many people also have allergies to these medications, so judicious evaluation of the risks/benefits need to be weighed.

Please see here – HO and Hip Arthroscopy

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