DOI: https://doi.org/10.22141/1608-1706.1.16.2015.80233

Diagnosis of Heterotopic Ossification in Patients with Spinal Cord Injury

M.A. Bystrytska, V.V. Povorozniuk

Abstract


Neurogenic heterotopic ossification (HO) is cha­racterized by the formation of a new additional bone tissue in the soft tissues surrounding the peripheral joints in patients with neurological disorders. The objective of the study was to define the features of bone remodeling in patients with vertebral and cerebrospinal injury (VCSI) and to isolate indicators specific to HO development.
Methods. Identification of bone remodeling markers (osteocalcin, P1NP, C-telopeptide cross-linked collagen type 1 (β-CTX)) in peripheral blood was carried out using electrochemiluminescence method on Elessys 2010 analyzer (Roche Diagnostics, Germany) by means of cobas test kits. The study included 23 patients with severe VSCI (Frankel A, B) with duration of posttraumatic period from 3 to 12 months (mean age 26.8 ± 3.9 years) — group I and 23 apparently healthy individuals matched for age and sex — group II (mean age 30.6 ± 6.0 years). Group I was divided into two subgroups according to HO presence: subgroup I — patients with VSCI and HO (n = 11), and subgroup II — patients with VSCI and without HO (n = 12).
Results of the study showed that the patients of the first group had significantly higher bone remodeling markers than those of the control group: P1NP (256.7 ± 48.2 ng/ml and 49.3 ± 5.1 ng/ml, respectively, p < 0.001), β-CTX (1.47 ± 0.23 ng/ml and 0.45 ± 0.04 ng/ml, respectively, p < 0.001), osteocalcin (52.2 ± 9.8 ng/ml and 24.90 ± 2.08 ng/ml,
respectively, p < 0.001). Among patients with VSCI, in persons with HO the levels of bone metabolism markers were significantly higher compared with patients who did not have HO: P1NP (404.9 ± 84.9 ng/ml
and 133.2 ± 15.7 ng/ml, respectively, p < 0.001), β-CTX (1.75 ± ± 0.23 ng/ml and 0.28 ± 0.14 ng/ml, respectively, p < 0.0001), osteocalcin (87.1 ± 18.9 ng/ml and 29.4 ± 3.7 ng/ml, respectively, p < 0.001).
Conclusion. Markers of bone tissue formation and resorption in patients of the first group were significantly higher than in healthy age-matched individuals. Indicators of bone metabolism markers in patients with HO were significantly higher than in patients without HO, and processes of bone tissue formation dominated the processes of resorption in patients with HO.


Keywords


heterotopic ossification; spinal cord injury; bone remodeling markers

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