Smoking linked to worsening degenerative disc disease in cervical spine

by / Monday, 22 February 2016 /

Adding to the already length list of reasons not to smoke, researchers have connected smoking to worsening degenerative disc disease in the cervical spine, according to research presented this week at the Association of Academic Physiatrists Annual Meeting in Sacramento, Calif.

The cervical spine is located in the neck and is made up of bones called vertebrae. Between these bones are cervical discs that absorb shock to the spine. Through the normal aging process, these discs slowly degenerate, which means they become dehydrated and shrink. This may result in a person experiencing chronic neck pain that may be difficult to treat. In some cases, the drying of the disc may result in the formation of cracks and tears, through which some of the jelly-like central portion of the disc may spill out and irritate local nerves, which much of the time results in pain in the shoulders, arms, hands and fingers.

It isn’t only wear and tear over time that can damage these discs. Some unhealthy habits, such as smoking, can add to cervical disc degeneration, according to Mitchel Leavitt, MD; resident physician at Emory University’s Department of Physical Medicine and Rehabilitation and the lead investigator of a new study looking at smoking and cervical disc disease. “Smoking is not healthy for a person’s intervertebral discs given the risk of developing microvascular disease – a disease of the small blood vessels – due to nicotine abuse,” Dr. Leavitt explains. “Intervertebral discs receive their nourishment from the microvasculature that line the endplates on either side of each disc; when these blood vessels are damaged, the discs do not receive nourishment and this may speed up the degenerative process.”

While smoking has been associated with degeneration in the lumbar spine (toward the base of the spine), no studies have been able to make this association with the cervical spine. To address this, Dr. Leavitt’s team evaluated the CT scans of 182 consecutive patients who were scanned for various reasons.

“There are more and more high-quality studies coming out that show an association between healthy lifestyle and improved quality and quantity of life as well as better disease management. Spine health is no different, and this study adds to existing studies that have looked at blood vessel health as it relates to chronic back pain,” Dr. Leavitt says.

The patients evaluated by Dr. Leavitt’s team were mostly female (57 percent), and 34 percent were smokers. The researchers utilized a radiologist with subspecialty training in neuroradiology and a physiatrist – a physician who specializes in physical medicine and rehabilitation – to review the CT scans, and they provided documentation on the severity of cervical degenerative disc disease.

Each disc was rated as normal (no loss of disc height), mild (one to 33 percent loss of disc height), moderate (34 to 66 percent loss of disc height), or severe with (greater than 66 percent loss of disc height or having a condition called vacuum disc where gas has accumulated in the discs). Based on this, scores of zero (normal) to three (severe) were given to each disc, and a cumulative cervical degenerative disc disease score was given for the entire cervical spine with a range of zero to 15.

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Elements as Published in Academic Physiatrists