The effects of extracorporeal shockwave therapy on the lumbar spine of osteoporotic rat models.

Authors

Kazuhiro Inomata, Eiji Takasawa, Yusuke Tomomatsu, Masaki Saito, Toshiki Tsukui, Tomoki Nakajima, Kenta Takakura, Akira Honda, Tokue Mieda, Hirotaka Chikuda

Published in

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. May 26, 2026. Epub May 26, 2026.

Abstract

Extracorporeal shockwave therapy (ESWT) is a noninvasive treatment known to promote angiogenesis and tissue regeneration. While preclinical studies on osteoporotic animal models have suggested its potential to increase bone mineral density (BMD) in long bones, the specific effect of ESWT on the osteoporotic spine has not been previously investigated. Therefore, the purpose of this study was to evaluate the effects of focused ESWT on BMD and bone formation parameters in the lumbar vertebrae using an ovariectomized (OVX) osteoporotic rat model.
Eighty female Sprague-Dawley rats underwent bilateral OVX at 8 weeks of age to induce osteoporosis, while 20 rats underwent sham surgery to serve as healthy controls. Twelve weeks post-surgery, the OVX rats were randomized into an untreated control group (n=20) or one of three ESWT treatment groups (n=20 per group). The treatment groups received 6 sessions of 1000 impulses of focused shockwaves applied to the fifth lumbar vertebra every other week at varying energy-fluxdensities (0.07, 0.15, or 0.25 mJ/mm²). The OVX control group received only anesthesia. The fifth lumbar vertebrae were harvested and analyzed using micro-computed tomography to measure cortical, cancellous, and planar BMD. Additionally, histomorphometry was performed to assess bone structural and kinetic parameters.
The OVX rats exhibited significantly lower cortical, cancellous, and planar BMD compared to the sham group, confirming the osteoporotic model. ESWT treatment resulted in increased BMD compared to the OVX control group. Specifically, the group treated with the highest energy density(0.25 mJ/mm²) demonstrated the most substantial improvements. Compared to the control group, this high-energy group showed significantly higher cancellous BMD (416 ± 36 vs. 375 ± 36 mg/cm³; p<0.01) and planar BMD (0.094 ± 0.008 vs. 0.086 ± 0.008 mg/cm²; p = 0.01). Histomorphometric analysis revealed that the ESWT-treated group had a smaller osteoid volume and osteoid surface compared to controls. Furthermore, the mineralization lag time was significantly shorter in the ESWT group than in the control group (0.95 ± 0.35 days vs. 2.12 ± 0.61 days; p = 0.02).
ESWT effectively increased BMD in the osteoporotic lumbar vertebrae of the OVX rat model. Histomorphometry indicated a reduction in osteoid volume and surface, alongside a shortened mineralization lag time, suggesting that ESWT may accelerate osteoid maturation. These findings suggest that ESWT could serve as a novel, noninvasive therapeutic strategy for managing spinal osteoporosis by improving bone density and modulating bone formation.

PMID:
42189220
Bibliographic data and abstract were imported from PubMed on 16 Jun 2026.

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