| Research Abstract |
Although various methods hove been reported to be effective for the treatment of skull defect, many problems remain to be solved mainly due to their invasiveness and/or use of foreign bodies. Recently, shock waves have been reported to induce bone growth, and clinically applied for the non-invasive treatment of delayed and non-union of long bones. To develop a new method to enhance bone growth at the skull without using foreign bodies is less invasive manner, we applied shock waves to the skull of young rats while protecting the brain and evaluated their effectiveness.
Fifty-five eight-week-old male Spregue-Dawley rats were each give 3 x 5 mm bone defect in the right parietal bone. During shock wave exposure, a 0.7mm thick extended polytetrafluoroethylene (ePTFE) sheet (GORE-TEX 【encircled R】 dura substitute), cut into 3.5 x 5.5mm piece was inserted between the dura and the skull to reduce shock wave propagation to the brain. The rats were divided into three groups according to the shoc
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k wave exposure patterns. Group A(n=15) served as control, and were not given shock wave treatment. Group B(n=20) received 500 shock waves on each side of the bone deficit for one day. Group C(n=20) had some treatment as Group B for five consecutive days. The shock waves were delivered via a holmium yttrium-aluminum-garnet laser-induced caviational shock wave generator, which was especially designed for use in the vicinity of brain and skull, with an overpressure of 50 bar, at a rate of 3 Hz. The bone gain rate was measured four weeks after shock wave exposure and specimens were also evaluated histologically. Additional brain specimens were obtained both at 24 hours (5 rats) and 4 weeks (5rats) after shock wave exposure and occurrence of brain damage was examined histologically.
Bone formation rate was 54.5±10.3 (%)) in Group B, which was significantly higher than that in Group A(37.l±13.5(%))(P<0.01), and even higher in Group C(74.1±14.5(%)). Histological specimens showed new bone formation along the side of internal lamina. There was no significant histological brain damage either in the acute and chronic periods after shock wave exposure. Present results show the possibility of applying shock wave as an alternative for cranioplasty without using foreign bodies. Less
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