Alcohol Abuse and Collagen Disruption: Effects on Skin Ultrasound Parameters in Lumbar Fusion Patients.

STUDY

DESIGN

Single-center cross-sectional analysis of a prospectively maintained database.

BACKGROUND CONTEXT: Alcohol abuse, defined by the NIAAA as excessive consumption leading to health risks contributes significantly to tissue degeneration through the damaging effects of acetaldehyde. Collagen type I, a critical structural protein in skin and bone, degrades in parallel across tissue types. Recent studies have linked dermal ultrasound (US) echogenicity to bone quality, but evidence supporting its utility as a biomarker for tissue degeneration remains limited. This study hypothesizes that alcohol abuse correlates with increased dermal US echogenicity, decreased skin thickness (ST), and poor tissue quality, supporting the potential use of US for preoperative bone quality assessment.

OBJECTIVE

To investigate the relationship between skin US parameters and alcohol abuse in lumbar fusion patients.

MATERIALS AND

METHODS

Patients undergoing lumbar fusion surgery with alcohol abuse (NIAAA criteria: >14 drinks/week in males, >8 in females) were included. Preoperative US measurements at two lumbar locations assessed echogenicity in the average dermal (AD), upper dermal (UD), and lower dermal (LD) layers. ST was measured at three dermal sites. Wilcoxon rank sum, Fisher Exact tests, and regression analyses adjusted for age, sex, and BMI were used (P<0.05).

RESULTS

Among 459 patients (50.5% male; median age 63.67 y; BMI 28.74 kg/m²), females exhibited higher US echogenicity (e.g. AD median 121 vs. 111.75; P<0.0001), while males had greater ST (2.97 vs. 2.65 mm; P<0.0001). Alcohol abuse was associated with increased LD echogenicity (14.86; P=0.038) and decreased ST (-0.35; P=0.034).

CONCLUSIONS

Alcohol abuse correlates with dermal layer degradation, as indicated by increased echogenicity and reduced ST. These findings highlight the potential utility of skin US as a preoperative biomarker for bone quality in lumbar fusion patients, warranting further investigation to enhance clinical applications.