Effect of Long-Term Smoking on Cervical Disc Degeneration: A Retrospective Study

BACKGROUND Although studies have shown that nicotine leads to disc degeneration, there is still a need for clinical and radiological studies. This study aimed to evaluate the effects of a smoking history of less than 10 years and of more than 10 years, compared with no smoking history, on cervical intervertebral disc degeneration at the C4-C5, C5-C6, and C6-C7 levels in 293 adult patients with documented degenerative changes, using magnetic resonance imaging (MRI) and the modified Pfirrmann grading system. MATERIAL AND METHODS A total of 293 adult patients with degenerative changes at C4-C5, C5-C6, and C6-C7 disc levels were included in this study. Patients were divided into 3 groups based on smoking duration: non-smokers (n=119), ≤10 years (n=93), and >10 years (n=81). Cervical disc degeneration was assessed using the modified Pfirrmann grading system, based on MRI findings. Each level was graded separately. Data were statistically analyzed to assess the relationship between smoking duration and disc degeneration. RESULTS Cervical disc degeneration at the C4-C5, C5-C6, and C6-C7 levels was significantly higher in both smoking groups (≤10 years and >10 years) than in the non-smoking group (P=0.023-<0.001). However, no statistically significant difference was observed between the ≤10-year and >10-year smoking groups at any level (P=0.250-0.989). Age and sex distributions were statistically similar across all groups (P>0.05). CONCLUSIONS This study provides radiological evidence that smoking accelerates cervical disc degeneration and highlights the clinical importance of smoking cessation in patients with cervical spine disorders.