this article and any supplementary material should be cited as follows: oleson cv, seidel bj, zhan...

This article and any supplementary material should be cited as follows: Oleson CV, Seidel BJ, Zhan T. Association of vitamin D deficiency, secondary hyperparathyroidism, and heterotopic ossification in spinal cord injury. J Rehabil Res Dev. 2013;50(9):XX–XX. http://dx.doi.org/10.1682/JRRD.2012.11.0206

Slideshow ProjectDOI:10.1682/JRRD.2012.11.0206JSP

Association of vitamin D deficiency, secondary hyperparathyroidism, and

heterotopic ossification in spinal cord injury

Christina V. Oleson, MD; Benjamin J. Seidel, DO; Tingting Zhan, PhD



• Aim– Explore relationship between low vitamin D,

secondary hyperparathyroidism, and heterotopic ossification (HO) in patients with spinal cord injury.

• Relevance– Many subjects with deficient vitamin D exhibit HO in

bones below neurological level of injury.



Method

• For 96 subjects:– Measured levels of serum vitamin D25(OH), calcium,

and intact parathyroid hormone (PTH).

– Obtained nutritional patterns and fracture history.

– Ascertained evidence of current or previous HO through chart review.



Results

• 12 subjects exhibited HO.– 11 with serum vitamin D25(OH) between

5–17 ng/mL.

• 9 subjects exhibited secondary hyperparathyroidism (72–169 pg/mL).

• Significant correlations found between: – Hyperparathyroidism and HO.– Hyperparathyroidism and vitamin D deficiency

(<20 ng/mL).



Conclusion

• No direct correlation between HO and low vitamin D, but hyperparathyroidism may increase risk.

• Patients with low vitamin D and elevated PTH should be screened for HO and begin vitamin supplementation. – Initiating early treatment of low vitamin D to restore

therapeutic levels may prevent HO development.

this article and any supplementary material should be cited as follows: oleson cv, seidel bj, zhan...

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