The Relationship Between Active and Passive Exposure to Cigarette Smoke and Severe Lumbar Intervertebral Disc Degeneration According to Demographic Data/Demografik Verilere Gore Sigara Dumanina Aktif ve Pasif Maruziyet ile Ciddi Lomber Intervertebral Disk Dejenerasyonu Arasindaki Iliski

• Published in: Bagcilar Medical Bulletin Vol. 6; no. 3; p. 220
• Main Author: Ulger, Fatma Esra Bahadir
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01-09-2021
• Subjects: Medical research; Medicine, Experimental; Physiological aspects; Smokers; Smoking
• ISSN: 2547-9431; 2547-9431
• DOI: 10.4274/BMB.galenos.2021.03.031

Objective: To investigate the effect of current, former and passive smoking status on degeneration of lumbar intervertebral discs. Method: Three hundred and sixty patients between the ages of 20 and 70 years, who underwent lumbar spinal magnetic resonance imaging, were included in the study. The patients were grouped according to their smoking status as current, former, passive smokers and nonsmokers. The cumulative smoking dose for current and former smokers was calculated in terms of pack-years and categorized further into two subgroups: smoked [less than or equal to] 9 pack-years or >9 pack-years. Patients who had been exposed to cigarette smoke for more than one year and more than one hour a day were included in the passive smoker group. The lumbar intervertebral discs were evaluated by the Pfirrmann disc degeneration grading system using sagittal T2-weighted magnetic resonance images. Grades IV and V were considered as "severe disc degeneration". Results: There was a statistically significant difference between smoking status and gender, age, body mass index and lumbar lordosis angle (p < 0.05). There was a statistically significant difference between smoking status and the presence of severe disc degeneration at L12, L2-3, L5-S1 levels (p < 0.05). The rate of severe intervertebral disc degeneration was low at L1-2 (15%) and gradually increased at other disc levels (L2-3: 20.3%, L3-4: 28.3%, L4-5: 47.2%, L5-S1: 53.6%). According to multivariate analysis, each unit increase in age was significantly associated with intervertebral disc degeneration at all levels (p < 0.05). Passive smoking was found to be significantly associated with L2-3 and L3-4 disc degeneration; and >9 pack-years current smoking was found to be significantly associated with L5-S1 disc degeneration (p < 0.05). Conclusion: There is a significant relationship between passive smoking and severe disc degeneration at upper lumbar levels. Also it was thought that quitting smoking could reverse some of the negative effects associated with smoking contributing to disc degeneration. Keywords: Current smoker, former smoker, intervertebral disc degeneration, magnetic resonance imaging, passive smoker, smoking Amac: Aktif, eski ve pasif sigara icme durumunun lomber intervertebral disklerin dejenerasyonuna etkisini arastirmaktir. Yontem: Calismaya lomber spinal manyetik rezonans goruntuleme yapilan 20-70 yas araliginda olan 360 hasta dahil edildi. Hastalar sigara icme durumlarina gore aktif, eski, pasif icici ve icmeyen olarak gruplandirildi. Aktif ve eski sigara icenler icin kumulatif sigara dozu paket yili cinsinden hesaplandi ve iki alt gruba ayrildi: [less than or equal to] 9 paketyil veya >9 paket-yil. Bir yildan fazla ve gunde bir saatten fazla sigara dumanina maruz kalan hastalar pasif icici grubuna dahil edildi. Lomber intervertebral diskler, sagital T2 agirlikli manyetik rezonans goruntuleri kullanilarak Pfirrmann disk dejenerasyon derecelendirme sistemi ile degerlendirildi. Grade IV ve V olarak tanimlanan diskler, "ciddi disk dejenerasyonu" olarak kabul edildi. Bulgular: Sigara icme durumu ile cinsiyet, yas, vucut kitle indeksi ve lomber lordoz acisi arasinda istatistiksel olarak anlamli bir fark vardi (p < 0,05). Sigara icme durumu ile L1-2, L2-3, L5-S1 seviyelerinde ciddi disk dejenerasyonu varligi arasinda istatistiksel olarak anlamli fark vardi (p < 0,05). Ciddi intervertebral disk dejenerasyonu orani L1-2'de (%15) dusuktu ve diger disk seviyelerinde kademeli olarak artti (L2-3: %20,3, L-34: %28,3, L4-5: %47,2, L5-S1: %53,6). Cok degiskenli analize gore, yastaki her bir birim artis tum seviyelerde intervertebral disk dejenerasyonu ile anlamli derecede iliskiliydi (p < 0,05). Pasif icicilik L2-3 ve L3-4 disk dejenerasyonu ile anlamli derecede iliskili bulunurken, >9 paket-yil aktif sigara icimi L5-S1 disk dejenerasyonu ile anlamli derecede iliskili bulundu (p < 0,05). Sonuc: Ust lomber seviyelerde pasif sigara icimi ile ciddi disk dejenerasyonu arasinda anlamli bir iliski vardir. Ayrica sigarayi birakmanin, disk dejenerasyonuna katkida bulunan bazi sigara ile ilgili olumsuz etkileri tersine cevirebilecegi dusunulmustur. Anahtar kelimeler: Aktif sigara icen, eski sigara icen, intervertebral disk dejenerasyonu, manyetik rezonans goruntuleme, pasif icicilik, sigara icme