Abstract
Study design:
Experimental study.
Objectives:
To determine the effects of extracorporeal shock wave lithotripsy (ESWL) on the rat spinal cord.
Methods:
Animals were randomly divided into three groups. Groups 1 and 2 consisted of five rats each that underwent ESWL (2000 impulses at 15 kV and 2000 impulses at 18 kV, respectively) and group 3 contained five control rats (no shock wave treatment). ESWL-treated and control rats were compared with regard to light and electron microscopic findings of the adjacent spinal cord.
Results:
Gross neurological outcomes were normal in all groups. Light microscopic examination of group 1 showed extensive extravasation of red blood cells over all the interstitial spaces. Group 2 also had haemorrhagic areas and an irregular organization of axons in the white matter. Transmission electron microscopic examination of group 1 indicated extravasated red blood cells through the endothelium and swollen axoplasm, degenerated mitochondria, destruction of myelin sheaths and a slight increase in the number of lysosomes. Extravasated red blood cells were also seen in group 2. The axoplasmic mitochondria were enlarged, but no sign of mitochondrial degeneration was observed. Lamellar degeneration of myelin sheaths and abundant lysosomes were more predominant in group 2 than in group 1.
Conclusion:
Extracorporeal shock wave lithotripsy caused not only haemorrhage but also damage to neuronal structures except the nucleus. Our findings showed that higher-energy ESWL caused more myelin degeneration in the spinal cord.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Lingeman JE, Matlaga BR, Evan AP . Surgical management of upper urinary tract calculi. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA (eds). Campbell–Walsh Urology, 9th edn. WB Saunders Elsevier: Philadelphia, PA, 2007, pp 1431–1506.
Stoller ML . Extracorporeal shock wave lithotripsy. In: Tanagho EA, McAninch JW (eds). Smith's General Urology, 14th edn. Appleton & Lange: Stamford, CT, 1995, pp 305–313.
Newman R, Hackett R, Senior D, Brock K, Feldman J, Sosnowski J et al. Pathologic effects of ESWL on canine renal tissue. Urology 1987; 29: 194–200.
Karawi MA, Mohamed AR, el-Etaibi KE, Abomelha MS, Seed RF . Extracorporeal shockwave lithotripsy (ESWL)-induced erosions in upper gastrointestinal tract. Prospective study in 40 patients. Urology 1987; 30: 224–227.
Finter F, Rinnab L, Simon J, Volkmer B, Hautmann R, Kuefer R . Ureteral stricture after extracorporeal shock wave lithotripsy: case report and overview of the spectrum of rare side effects of modern ESWL treatment. Urologe A 2007; 46: 769–772.
Turgut M, Can C, Yenilmez A, Akcar N . Perforation of the upper ureter: a rare complication of extracorporeal shock wave lithotripsy. Urol Res 2007; 35: 215–218.
McCullough DL, Yeaman LD, Bo WJ . Effects of shock waves on the rat ovary. J Urol 1989; 141: 666–669.
Moran ME, Sandock D, Bottaccini MR . Chick embryo model to study effects of high energy shock waves on rapidly proliferating tissues. J Endourol 1990; 4: 315.
Ridet JL, Pencalet P, Belcram M . Effects of spinal cord X-irradiation on the recovery of paraplegic rats. Exp Neurol 2000; 161: 1–14.
Rigatti P, Colombo R, Centemero A, Francesca F, Di Girolamo V, Montorsi F et al. Histological and ultrastructural evaluation of extracorporeal shock wave lithotripsy-induced acute renal lesions: preliminary report. Eur Urol 1989; 16: 207–211.
Weber C, Moran ME, Braun EJ, Drach GW . Injury of rat renal vessels following extracorporeal shock wave treatment. J Urol 1992; 147: 476–481.
Lorenzo ND, Maleci A, Williams BM . Severe exacerbation of post traumatic syringomyelia after lithotripsy. Paraplegia 1994; 32: 694–696.
Tosi L, Terini G . Lithotripsy in SCI patients. Letter. Paraplegia 1995; 33: 364.
Newman RC, Hackett RL, Brock KA . Effect of ESWL on canine spinal cord. Urology 1987; 29: 116.
Totoiu MO, Keirstead HS . Spinal cord injury is accompanied by chronic progressive demyelination. J Comp Neurol 2005; 486: 373–383.
Acknowledgements
This study was supported by a grant from the Turkish Neurosurgical Society.
Author information
Authors and Affiliations
Corresponding author
Additional information
The English in this document has been checked by at least two professional editors, both native speakers of English. For a certificate, see: http://www.textcheck.com/cgi-bin/certificate.cgi?id=tMniUx.
Rights and permissions
About this article
Cite this article
Karatas, A., Dosoglu, M., Zeyrek, T. et al. The effect of extracorporeal shock wave lithotripsy on the rat spinal cord. Spinal Cord 46, 627–632 (2008). https://doi.org/10.1038/sc.2008.31
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sc.2008.31


