SCI Complications Flashcards
Define heterotopic ossification
Bone (not just calcium) in soft tissue near the joint.
When does a heterotopic ossification happen?
Occurs in paralyzed part of the body with SCI, TBI.
With a SCI, __________ are the most common site of HO.
Hips
With a TBI, _________ are the most common site of HO.
Elbows (hemi side)
HO grows ____ times faster than normal bone.
3 times faster
What is the incidence rate for HO with SCI or TBI?
20%
When does HO typically onset after injury?
1-3 months
What fraction of patients with HO experience symptoms vs no symptoms?
1/3 experience symptoms
2/3 no symptoms
Two major symptoms of HO:
Loss of ROM
Inflammation of the limb
What do you always need to do first when you suspect HO?
check for DVT
T/F Xray can usually catch HO early on.
False. Often misses HO in early stages
With osteoporosis, males lose ____% of bone density.
33%
With osteoporosis, females lose ____% of bone density.
40%
Two causes of osteoporosis:
Lack of weight bearing
Abnormal autonomic nerve signals to the bone in paralyzed part of the body.
Five things to consider when treating osteoporosis:
Don’t overtreat spasticity (help with bone density)
Bisphosphonates (inhibit osteoclast activity)
Early standing program using standing frames (30 min a day)
Calcium and vit D
Get X-ray for any bruises or swelling as it could be a fracture.
What persons with SCI experience spasticity?
65-78%
In what percent of people who experience spasticity is it problematic?
28-43%
What percentage of people who experience spasticity need medication?
43-49%
Is spasticity more common in complete or incomplete SCI?
incomplete
Is spasticity more common in Tetraplegic or paraplegic cases?
Tetraplegic
Is spasticity more common in the arms or the legs?
Legs
Is flexion spasticity more or less common than extensor spasticity?
Extension is more common
Medications for spasticity (5):
Baclofen, Tizanidine, Clonidine, Dantrolene, Clonazepam
What injection can help with spasticity? How often?
Botox every 3 months
What implant can help with spasticity?
Intrathecal baclofen pump (micro doses directly to spinal cord).
What modality can help reduce spasticity? What do you need to consider?
E-stim.
Short lived benefits. Some can have increased spasticity. Worth trying but may not be good fit depending on individual.
