The relationship between smoking and lumbar disc degeneration

English Keywords:Lumbar discs degeneration  Smoking  Low back pain

English Abstract:

  【Abstract】 Objectives: To discuss the relationship between smoking and lumbar disc degeneration(LDD). Methods: 200 adult male patients in our spine clinic for the first time due to low back pain from January 2014 to December 2014 were selected. The demographic data including age, height, weight, diabete history, high blood pressure history, alcohol addict history, smoking history and career were collected. The patients were divided into two groups according to their smoking history. Each patient had a lumbar MRI scan and patients with lumbar trauma, infection, tumor and deformity were excluded. Each level of the discs was graded by the Pfirrmann grading system, and the severity of low back pain was graded by the VAS score. The data were analyzed by SPSS 19.0. Results: Demographic data like age, body mass index(BMI), diabete history, high pressure history and alcohol addict history showed no differences between the two groups(P>0.05). In Pfirrmann 4 and 5, the smoking group showed higher disc number proportions than the non-smoking group(P<0.05). The two groups showed significant differences in Pfirrmann 2, 4, 5 in L1/2, Pfirrmann 2, 4 in L2/3, Pfirrmann 2, 3, 4, 5 in L3/4, Pfirrmann 3, 4 in L4/5 and Pfirrmann 3, 5 in L5/S1(P<0.05). In the smoking group, the disc number proportion of Pfirrmann 4 and 5 in the upper disc levels was higher than in the lower levels, which was statistically significant(P<0.05). Moreover, the average VAS score of the smoking group was higher than that of the non-smoking group(P<0.05). Conclusions: Smoking appears to contribute to the progression of LDD and it can aggravate the severity of low back pain. Furthermore, smoking seems to have more impact to the upper discs than the lower discs.