Back, Spine, & Nerves

A prospective, randomized, controlled, single centre trial to assess the efficacy and safety of radial extracorporeal shockwave therapy in patients with chronic non-specific low back pain -  (Balagué et al., 2012). Non-specific low back pain is common and affects people of all ages (e.g., Carraggee, 2005; Bhangle et al., 2009; Maher et al., 2017). Non-specific low back pain is defined as low back pain not attributable to a recognizable, known specific pathology (e.g., infection, tumour, osteoporosis, fracture, structural deformity, inflammatory disorder, radicular syndrome, or cauda equina syndrome)

Prof. M. Kravchik. Focused shockwave therapy in the treatment of the spine. Oxford, UK Non-invasive treatment of herniated discs by focused shock wave therapy - (​Non-invasive treatment of herniated discs by focused shockwave therapy) - In orthopedic practice meets a number of pathologies, surgical treatment which is necessary because of the inefficiency of the traditional conservative therapy. These pathologies, in particular, diseases of the spine - such as protrusion, herniated disc, low back pain, osteoporosis and spondylitis. At present, there are solutions of non-surgical treatment of these diseases - manual therapy, skeletal traction, epidural blockade, physiotherapy etc.

The efficacy of ultrasound-guided extracorporeal shockwave therapy in patients with cervical spondylosis and nuchal ligament calcification -(Tz-Yan Lin, Jing-Ting Chen, Yu-Yu Chen, Tien-Wen Chen , Chia-Ling Lee, Chia-Hsin Chen, Mao-Hsiung Huang) - We investigated the effects of extracorporeal shockwave therapy (ESWT) on the rehabilitation of cervical spondylosis with nuchal ligament (NL) calcification under X-ray and ultrasound guidance. Sixty patients with cervical spondylosis and calcification of NL were selected and randomly assigned to three groups: A, B, and C.

Shock wave treatment protects from neuronal degeneration via a toll-like receptor 3 dependent mechanism: implications of a first-ever causal treatment for ischemic spinal cord injury - Paraplegia following spinal cord ischemia represents a devastating complication of both aortic surgery and endovascular aortic repair. Shock wave treatment was shown to induce angiogenesis and regeneration in ischemic tissue by modulation of early inflammatory response via Toll-like receptor (TLR) 3 signaling. In preclinical and clinical studies, shock wave treatment had a favorable effect on ischemic myocardium. We hypothesized that shock wave treatment also may have a beneficial effect on spinal cord ischemia.

The Effects of Extracorporeal Shock Wave Therapy in Patients with Coccydynia: A Randomized Controlled Trial -(Shih-Feng Lin, Yi-Jen Chen, Hung-Pin Tu , Chia-Ling Lee, Ching-Lin Hsieh , Wen-Lan Wu , Chia-Hsin Chen) - Coccydynia is pain in the coccygeal region, and usually treated conservatively. Extracorporeal shock wave therapy (ESWT) was incorporated as non-invasive treatment of many musculoskeletal conditions. However, the effects of ESWT on coccydynia are less discussed.

Extracorporeal shock wave therapy relieved pain in patients with coccydynia: a report of two cases -(Yousef Marwan, MBBS, Wael Husain, MBBS, FRCSC , Waleed Alhajii, MBBS, MSc, Facharztb , Magdy Mogawer, MBBS) - Extracorporeal shock wave therapy (ECSWT) has been used widely for musculoskeletal conditions; however, no reports are available about its use for coccydynia.

Extracorporeal shock wave therapy for the treatment of coccydynia: a series of 23 cases - (Yousef Marwan, • Bashar Dahrab • Ali Esmaeel • Samir Abdulrazik Ibrahim • Jassim Al-Failakawi) - Coccydynia can lead to significant functional disability and worsening of quality of life if not properly managed. In this study, we aim to assess the outcomes of extracorporeal shock wave therapy in patients with coccydynia.

Mechano-transduction effect of shock waves in the treatment of lumbar facet joint pain:Comparative effectiveness evaluation.... - (Charles University in Prague, 2nd Faculty of Medicine, Department of Neurology, Prague, Czech Republic Center for Rehabilitation and Treatment of Spine Pain, Prague, Czech Republic  Czech Technical University, Faculty of Biomedical Engineering, Kladno, Czech Republic  Bridgeland Sport and Spine Center, Calgary, Canada) -  Lumbar facet joints (FJ) is a common source of low back pain and contributes approximmately on one third of chronic low back pain. Medial branch radiofrequency neurotomy is considered as a gold standard in the treatment of facet joint pain. Corticosteroid injections have also presented effect in FJ pain.

Extracorporeal shockwave therapy versus exercise program in patients with low back pain: short-term results of a randomized controlled trial - (Notarnicola, Maccagnano, Gallone, Mastromauro, Rifino, Pesce, Covelli , Moretti B) The physiotherapy treatment of low back pain (LBP) with physical stimulation offers different possibilities of application. Until now, the physical therapies used in LBP are laser therapy, ultrasonotherapy and currents.

Effectiveness of extracorporeal shock wave for low back pain (A protocol of systematic review) - (​Wei Wei, Hua-yu Tang, Yu-zhi Li, Tian-shu Wang) - : Previous clinical trials have reported that extracorporeal shock wave (EPSW) can be used to treat low back pain (LBP), and have achieved satisfied effect. However, its effectiveness is still inconclusive. Thus, this systematic review will aim to assess the effectiveness and safety of EPSW for patients with LBP.

Effects of Extracorporeal Shockwave Therapy on Patients with Chronic Low Back Pain and Their Dynamic Balance Ability - (Department of Physical Therapy, Youngdong University) - [Purpose] The purpose of the present study was to examine the effects of extracorporeal shockwave therapy (ESWT) for patients with chronic low back pain and their dynamic balance ability. [Subjects] Twenty-eight patients with chronic low back were divided into an extracorporeal shockwave therapy group (ESWTG: n=13) and a conservative physical therapy group (CPTG, n=15).

Spark Wave® Therapy – a New Method for Peripheral Nerve Regeneration -(MTS Science) - Peripheral nerve injuries affect millions of people every year. After trauma or surgery, patients often require autologous nerve grafting, which is the „gold standard“, but nevertheless a complex and demanding surgical procedure with low chances of success. The choice of graft type and optimal regeneration conditions are crucial for the final result.Scientists of the Ludwig-Boltzmann-Institute in Vienna rise to the challenge by utilizing Spark Wave Technology which is, due to its cell activating effect in various tissues, a highly emergent technology in the field of regenerative medicine (e. g. in urology and orthopaedics).

Benefits of Spark Wave Therapy in neuronal regeneration - (MTS Science) - Extracorporeal shock wave therapy (ESWT) is widely used in clinical practice. In addition to its original use in kidney stone disintegration, shock waves are now used for the treatment of a variety of regenerative indications. Mechanotransduction stimulates the body’s biological healing processes at the cellular level. In areas of wound healing, orthopaedics or erectile dysfunction, very good, well-founded treatment successes are achieved.

Symptomatic treatment of unresponsive wakefulness syndrome with transcranial focused extracorporeal shock waves - (​H. Lohse-Busch, U. Reime and R. Falland Outpatient Department for Manual Medicine – Movement Disorder Center, Rheintalklinik, Bad Krozingen, Germany) - Can stimulation of nerve growth factors by focused transcranial extracorporeal shock wave therapy (TESWT) be made effective for persons within unresponsive wakefulness syndrome (apallic syndrome)? 

Extracorporeal shockwave treatment: A novel tool to improve Schwann cell isolation and culture - (​AUVA Research Center, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology,Vienna, Austria, 2 Austrian Cluster for Tissue Regeneration,Vienna, Austria, and 3 Department of Biochemical Engineering, University of Applied Sciences TechnikumWien,Vienna, Austria) - As new approaches for peripheral nerve regeneration are sought, there is an increasing demand for native Schwann cells for in vitro testing and/or reimplantation. Extracorporeal shockwave treatment (ESWT) is an emergent technology in the field of regenerative medicine that has also recently been shown to improve peripheral nerve regeneration. Methods. In this study, we elucidate the effects of ESWT on Schwann cell isolation and culture.

The Biologic Effects of SoftWaves™and Rationale for Spine and Brain Therapy - Shock waves are defined as types of acoustic pressure waves that develop during sudden releases of energy. The best-known natural phenomenon is thunder following lightning. Another example is the “bang” an aircraft produces when it breaks the sound barrier. Both focused shock waves and unfocused sound waves are produced in these examples. Additionally, almost all other forms of energy are released during these natural discharges, including electrical, heat, light, and electromagnetic energy. Since the first medical application of acoustic waves was the disintegration of kidney stones in the early 1980’s, high energy, focused shock waves were the first to be studied and understood.

Shock wave treatment protects from neuronal degeneration via a toll-like receptor 3 dependent mechanism: implications of a first-ever causal treatment for ischemic spinal cord injury - (Daniela Lobenwein, MD; Can Tepek€oyl€u, MD; Radoslaw Kozaryn, MD; Elisabeth J. Pechriggl, MD; Mario Bitsche, Msc; Michael Graber; Helga Fritsch, MD; Severin Semsroth, MD; Nadia Stefanova, MD; Patrick Paulus, MD; Martin Czerny, MD; Michael Grimm, MD; Johannes Holfeld, MD) - Paraplegia following spinal cord ischemia represents a devastating complication of both aortic surgery and endovascular aortic repair. Shock wave treatment was shown to induce angiogenesis and regeneration in ischemic tissue by modulation of early inflammatory response via Toll-like receptor (TLR) 3 signaling. In preclinical and clinical studies, shock wave treatment had a favorable effect on ischemic myocardium. We hypothesized that shock wave treatment also may have a beneficial effect on spinal cord ischemia.

Low energy shock wave therapy induces angiogenesis in acute hind-limb ischemia via VEGF receptor 2 phosphorylation - (​University Hospital for Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria, 2 Division of Clinical and Functional Anatomy, Department of Anatomy, Histology and Embryology, Innsbruck Medical University, Innsbruck, Austria, 3 University Hospital for Dermatology and Venerology, Innsbruck Medical University, Innsbruck, Austria, 4 University Hospital for Internal Medicine III, Department of Cardiology and Angiology, Innsbruck Medical University, Innsbruck, Austria, 5 Clinic of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe-University Hospital, Frankfurt am Main, Germany) - : Low energy shock waves have been shown to induce angiogenesis, improve left ventricular ejection fraction and decrease angina symptoms in patients suffering from chronic ischemic heart disease. Whether there is as well an effect in acute ischemia was not yet investigated.

Extracorporeal shock wave therapy (ESWT) for the treatment of spasticity in persons with spinal cord injury - (Swiss Paraplegic Centre Nottwil) - Spasticity is the most problematic self-reported secondary medical problem in patients with spinal cord injury. It has the potential to negatively influence quality of life through restricting activities of daily living. Problematic spasticity can cause pain and fatigue, disturb sleep, contribute to the development of contractures and pressure ulcers, and has a negative effect on patients morbidity. For this reason there is enormous interest in therapeutic interventions addressing to decrease spasticity in persons with spinal cord injury. Recently, studies reported positive effects of extracorporeal shock wave therapy on spasticity in patients with stroke, focal limb dystonia and cerebral palsy. To date, no studies are published, assessing the effect of extracorporeal shock wave therapy on focal spasticity in patients with spinal cord injury.

Symptomatic treatment of unresponsive wakefulness syndrome with transcranial focused extracorporeal shock waves - ​(Outpatient Department for Manual Medicine – Movement Disorder Center, Rheintalklinik, Bad Krozingen, Germany) - Can stimulation of nerve growth factors by focused transcranial extracorporeal shock wave therapy (TESWT) be made effective for persons within unresponsive wakefulness syndrome (apallic syndrome)?

Shockwave therapy differentially stimulates endothelial cells: implications on the control of inflammation via toll-like receptor 3 - (Johannes Holfeld, Can Tepeköylü, Radoslaw Kozaryn, Anja Urbschat, Kai Zacharowski, Michael Grimm, and Patrick Paulus) - Shock wave therapy (SWT) reportedly improves ventricular function in ischemic heart failure. Angiogenesis and inflammation modulatory effects were described. However, the mechanism remains largely unknown. We hypothesized that SWT modulates inflammation via toll-like receptor 3 (TLR3) through the release of cytosolic RNA. SWT was applied to human umbilical vein endothelial cells (HUVECs) with 250 impulses, 0.08 mJ/mm2 and 3 Hz.

Low-energy shock wave for enhancing recruitment of endothelial progenitor cells: a new modality to increase efficacy of cell therapy in chronic hind limb ischemia - (Alexandra Aicher, MD; Christopher Heeschen, MD; Ken-ichiro Sasaki, MD; Carmen Urbich, PhD; Andreas M. Zeiher, MD; Stefanie Dimmeler, PhD) - Stem and progenitor cell therapy is a novel approach to improve neovascularization and function of ischemic tissue. Enhanced tissue expression of chemoattractant factors such as stromal cell–derived factor 1 and vascular endothelial growth factor is crucial for the recruitment of circulating endothelial progenitor cells (EPCs) during acute ischemia. In chronic ischemia, however, expression of these chemoattractants is less pronounced, which results in insufficient EPC recruitment into the target tissue. Therefore, we investigated the effect of targeted extracorporeal shock wave (SW) application in order to facilitate EPC recruitment into nonischemic and chronic ischemic tissue.