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

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