Effect of High-Energy Shock Waves on Bony Tissue

The indication for extracorporeal shock-wave lithotripsy (ESWL) in the treatment of lumbar and distal ureteral stones is well established. Ureteral calculi projecting onto the bony structures of the pelvis are not amenable to ESWL. Treatment options would include shock-wave treatment with the patient in a prone position where shock waves would pass through intestinal structures, or in a supine position where shock waves would traverse the pelvic bones. In order to investigate the effect of high-energy shock waves on bony tissue, an experimental study was undertaken using 26 female rabbits weighing 2.3–4.4 kg. Under intravenous anesthesia, the left anterior iliac spine and the left distal femur were each exposed to 1500 shocks. A generator voltage of 20 kV (1000 bars) and 25 kV (1300 bars) was used in each of two groups of 12 rabbits. Treatments were performed using the Dornier HM3 lithotripter. Four animals from each group were sacrificed after 2, 14, and 21 days following shock wave. A thorough necropsy examination was performed and all exposed tissues were examined histologically.