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.