Cobb angle, vertebral deformity and fractures in alcoholic patients

Background: Hypercyphosis and vertebral deformity are related to vertebral fractures. There are no studies in chronic alcoholics. Objective: To analyse the relationship which exists between the Cobb angle and different degrees of vertebral deformity, and bone mass and various variables related to bone metabolism in chronic alcoholic patients. Material and methods: 57 alcoholic males aged 52 ± 12 years were included. The Cobb angle was calculated and the degree of vertebral deformity of T7, T8, T9 and T10 was measured using MorphoXpress and thoracic X-ray. The bone mass in the spine and hip were determined using a DXA Hologic Walthan 2000, and exiting clinical fractures with the clinical history. In addition, the nutritional state, the degree of alcoholism, variables of hepatic function, the presence of hepatic cirrhosis, and bone metabolism, were analysed. The results were also studied in 20 controls of similar age and of the same sex. Results: The patients had a greater Cobb angle in comparison with the controls ( 30 ± 9o vs 17 ± 5o, respectively, p<0.001). Those with cirrhosis had lower bone mass than those without in the lumbar vertebrae (p<0.01) and femoral neck (p=0.02). The deformities in T7, T8, T9 and T10 were associated with a greater cyphosis, longer period of consumption and with existing vertebral fractures (p<0.01), non-vertebral fractures (p<0.002) and hip fractures (p<0.001). There were 65 existing fractures, 46 in the rib, 12 vertebral and 7 in the hip. The patients with a higher Cobb angle had more vertebral (p<0.01) and nonvertebral (p=0.04) fractures, as well as a longer period of alcohol consumption (p=0.02). Conclusions: Chronic alcoholics have greater cyphosis than the controls. Wedge or biconcave vertebral deformities are related with a greater cyphosis, higher consumption of alcohol and existing fractures. In this series a higher Cobb angle is related to existing vertebral fractures. The most intensive drinkers had a higher Cobb angle and more fractures.