Blocking neuromuscular junctions with botulinum toxin A injection enhances neurological heterotopic ossification development after spinal cord injury in mice

Dear Editor, Neurogenic heterotopic ossifications (NHOs) are benign ectopic bones that develop within the muscle tissue surrounding extracapsular bone joints [1] after severe lesions of the central nervous system (CNS) such as spinal cord injury (SCI) or traumatic brain injury [2]. NHOs are often diagnosed late, thereby resulting in large ossifications causing joint pain and stiffness that often progress to partial or complete joint ankyloses. Complications such as nerve and blood vessel compression and skin bedsores occur further exacerbate patient morbidity. Occurrence of NHO delays recovery from injury, interrupts rehabilitation programs and lengthens the hospital stay [3]. There is no effective pharmacological treatment to reduce the burden of NHO. Surgical resection of troublesome NHO remains the only treatment and provides some benefit for mobility [3].