Abstract
Introduction: Intrauterine protein restriction in rats is associated with low bone mass which persists with development through to adulthood. However, such adverse effects are not only restricted to bone. Intervertebral discs are the largest avascular structures in the body, and are particularly sensitive to their nutritional environment. We have examined the hypothesis that changes in the intervertebral disc (or ligaments), as a result of early nutritional compromise, affect the spine’s mechanical properties.
Material and methods: Lumbar spines were removed from 8 sheep (6 male, 2 female: mean age 2.7 yrs) that had received different diets early in their development: two animals received a control diet, three received low protein in utero (IU), and three received low protein both in utero and postnatally (PN). Fifteen motion segments (consisting of two vertebrae and the intervening disc and ligaments) were dissected from the spines and tested on a hydraulically-controlled materials testing machine. Compressive stiffness and bending stiffness were measured before and after creep loading, in both flexion and extension. Reflective markers attached to the specimens were tracked during loading, enabling intervertebral angles to be calculated. Bending moment-angular rotation curves were used to calculate bending stiffness. Repeated measures ANOVA was used to test for differences in stiffness with posture and creep, and between the dietary groups.
Results: Compressive stiffness increased after creep loading (p=0.002) but was unaffected by posture or dietary group. In contrast, bending stiffness was unaffected by creep but differed significantly between groups and with posture. When compared to controls, bending stiffness in the IU group was reduced by 35% in flexion and 26% in extension (p< 0.02). In the PN group, reductions of 28% in flexion and 15% in extension were observed (p=0.056).
Discussion: These results indicate that early protein restriction can affect the mechanical properties of the spine. These effects were evident in bending but not in compression, and tended to be greater in flexion than extension. These preliminary findings suggest that early protein restriction may affect the composition and mechanical function of the annulus fibrosus and the intervertebral ligaments which are the structures most involved in resisting flexion movements.
Correspondence should be addressed to Mr Carlos Wigderowitz, Senior Lecturer, University Department of Orthopaedic and Trauma Surgery, Ninewells Hospital and Medical School, Dundee DD1 9SY.
