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Ketogenic diet delays spinal fusion and decreases bone mass in posterolateral lumbar spinal fusion: an in vivo rat model

  • Qi Liu
  • Xiaomeng Wang
  • Zucheng Huang
  • Junhao Liu
  • Jianyang Ding
  • Xiaolin Xu
  • Ganggang Kong
  • Xiuhua Wu
  • Zhou Yang
  • Qingan Zhu
Original Article - Spine - Other
  • 14 Downloads
Part of the following topical collections:
  1. Spine - Other

Abstract

Background

Ketogenic diet (KD), a low-carbohydrate-and-high-fat diet, causes a metabolic state of ketogenesis and has been used to treat drug-resistance epilepsy. Our recent studies showed KD neuroprotective after spinal cord injury and causing bone loss. Effects of KD on spinal fusion were still unknown. This study was aimed to evaluate effects of KD on spinal fusion in rats.

Methods

Thirty-two Sprague-Dawley rats were randomly divided into KD and standard diet (SD) groups. The KD group was fed with food of 1:4 carbohydrates to fat. All rats were subjected to L4/5 posterolateral lumbar spinal fusion. The blood ketone, and serum calcium, phosphorus, and insulin-like growth factor-1 (IGF-1) were measured, as well as the fusion rates, bone mass (BV), and bone mineral contents (BMC) of fusion sites were estimated at 4 and 8 weeks.

Results

There was no significant difference in serum calcium or phosphorus levels between groups at 4 or 8 weeks. However, there was a significant increase of blood ketone (1.02 mmol/L vs 0.38 mmol/L at 4 weeks; 0.83 mmol/L vs 0.32 mmol/L, at 8 weeks) and decrease of serum IGF-1 (339.4 ng/mL vs 630.6 ng/mL at 4 weeks; 418.8 ng/mL vs 628.6 ng/mL, at 8 weeks) in the KD group compared with the SD group. The spinal fusion occurred less in the KD group (1/16 vs 6/16 at 4 weeks; 7/16 vs 10/16, at 8 weeks), particularly at 4 weeks after surgery. The BV and BMC were lower in the KD group than that in the SD group at 4 weeks, but not different between groups at 8 weeks.

Conclusions

This study demonstrated that KD delayed spinal fusion and decreased bone mass in posterolateral lumbar spinal fusion in rats.

Keywords

Bone fusion Bone volume Ketogenic diet Posterolateral spinal fusion Rats 

Notes

Acknowledgements

QZ, QL, and XW designed the experiments. QL, XW, ZH, and JH conducted the animal experiments. QL wrote the manuscript. XW and GK completed the data analysis, and QZ revised the manuscript.

Funding

This study was supported by the National Natural Science Foundation of China (No. 81472084) and Natural Science Foundation of Guangdong (No. 2014A030313336).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Qi Liu
    • 1
  • Xiaomeng Wang
    • 2
  • Zucheng Huang
    • 1
  • Junhao Liu
    • 1
  • Jianyang Ding
    • 1
  • Xiaolin Xu
    • 1
  • Ganggang Kong
    • 1
  • Xiuhua Wu
    • 1
  • Zhou Yang
    • 1
  • Qingan Zhu
    • 1
  1. 1.Department of Spinal Surgery, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
  2. 2.Department of Spinal SurgeryLongyan Frist HospitalLongyanChina

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