Smoking
linked to worsening degenerative disc disease in cervical spine. DRX9000 or ISCS Can Help
BY
ADMIN / MONDAY, 22 FEBRUARY 2016 /
Smoking linked to worsening degenerative disc disease in cervical spine & the DRX9000 or ISCS can help. 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.
The
researchers considered each patient’s smoking status and his or her number of
pack years smoked, which is the number of packs of cigarettes the patient
smokes each day multiplied by the number of years he or she has smoked.
Finally, the researchers collected and considered other health information such
as age, body mass index, high blood pressure (called hypertension), high
cholesterol and diabetes.
Current
smokers were found to have more cervical degenerative disc disease by one
point, on average. Additionally, the researchers found that increased age was
associated with worsening cervical degenerative disc disease, but co-existing
diseases – such as diabetes, hypertension, high cholesterol and high BMI – were
not associated with the disease.
“This
is another example of the detrimental effects of smoking. Tobacco abuse is
associated with a variety of diseases and death, and there are lifestyle
factors associated with chronic neck pain,” explains Dr. Leavitt of the study’s
findings. “Pain and spine clinics are filled with patients who suffer chronic
neck and back pain, and this study provides the physician with more ammunition
to use when educating them about their need to quit smoking.”
Dr.
Leavitt suggests more research should be conducted on other lifestyle factors
(e.g., diets high in fat vs. plant-based, alcohol use, obesity, etc.) as they
relate to chronic back and neck pain, as well as identifying any objective
changes on advanced imaging or autopsy.
“As
the population continues to get older, more and more patients are wanting, if
not demanding, that they be given the opportunity to be as active as they were
in their 40s. They want to play golf, run triathlons, work in their garden,
etc.; however, chronic pain originating from the spine makes these activities
difficult,” says Dr. Leavitt. “Virtually everyone knows that moderate exercise
somewhere around four to five times per week is beneficial, plus other
lifestyle factors like avoidance of smoking and a proper diet are equally
important. However, these topics are usually geared towards heart health,
lowering blood pressure, managing diabetes, or controlling other medical
conditions, and not specific to the spine. It is one thing to live to the age
of 95, and it is another to live to 95 while retaining one’s mobility and being
free of pain. Lifestyle medicine will likely play a large role in the future of
healthcare, and having plenty of data to support lifestyle management is
critical for a provider who practices evidenced-based medicine. The lifestyle
approach may allow us to not only live longer and healthier lives, but we may
also be able to take less medication in the process, thereby sparing us the
risk of medication side effects.”
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Elements as
Published in: Academic Physiatrists
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