The effect of extracorporeal shock wave lithotripsy on the rat spinal cord

• Published in: Spinal cord Vol. 46; no. 9; pp. 627 - 632
• Main Authors: Karatas, A, Dosoglu, M, Zeyrek, T, Kayikci, A, Erol, A, Can, B
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.09.2008; Nature Publishing; Nature Publishing Group
• Subjects: Anatomy; Animals; Axons - pathology; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cerebrospinal fluid. Meninges. Spinal cord; Erythrocytes - pathology; Hemorrhage - etiology; Hemorrhage - pathology; Hemorrhage - physiopathology; Human Physiology; Injuries of the nervous system and the skull. Diseases due to physical agents; Kidney Calculi - therapy; Lithotripsy - adverse effects; Lysosomes - pathology; Male; Medical sciences; Microcirculation - pathology; Microcirculation - physiopathology; Microscopy, Electron, Transmission; Mitochondria - pathology; Nerve Fibers, Myelinated - pathology; Nervous system (semeiology, syndromes); Neurochemistry; Neurology; Neuropsychology; Neurosciences; original-article; Rats; Rats, Wistar; Spinal Cord - blood supply; Spinal Cord - pathology; Spinal Cord - physiopathology; Spinal Cord Injuries - etiology; Spinal Cord Injuries - pathology; Spinal Cord Injuries - physiopathology; Traumas. Diseases due to physical agents; Wallerian Degeneration - etiology; Wallerian Degeneration - pathology; Wallerian Degeneration - physiopathology; cord; electron microscopy; spine; extracorporeal shock wave lithotripsy; Shock; Spinal cord; Nervous system diseases; Vertebral canal; Rat; Spine; Rodentia; Central nervous system; Electron microscopy; Osteoarticular system; Vertebrata; Mammalia; Animal; Central nervous system disease; Spinal cord disease
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sc.2008.31

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.