Adem Bozkurt Aras, Mustafa Güven, Tarık Akman, Ayla Akbal, Ferhat Gökmen, Ergün Karavelioğlu, Özlem Yener, Murat Coşar

Lomber Disk Dejenerasyonu ile Sigara Kullanımı Arasındaki İlişki

Bu çalışmanın amacı sigara kullanımının bel ağrısı ile ilişkisi olup olmadığını belirlemekti.Çalışmamıza, beyin ve sinir cerrahi polikliniğine bel ağrısı nedeniyle başvurmuş olup ve lomber disk hernisi ön tanısı ile Lomber MRG yapılan olgularda, Lomber MRG değerleri pozitif olan, 15-70 yaş arası 200 hasta dahil edildi; olguların öyküleri ,yakınmaları ve sigara içip içmedikleri kayıt altına alındı. Sistemik hastalığı olanlar ve yaş aralığı dışındakiler değerlendirmeye alınmadı.Gruplar karşılaştırıldığında sigara kulanımının dejenerasyon üzerine etkisi olmadığı tespit edildi. Sigara kullanımının lomebr disk dejenerasyonu ile ilişkili bir risk faktörü olmadığı kanısına varıldı.

Anahtar Kelimeler:

İntervertebral disk dejenerasyonu, lomber vertebra, risk faktörleri, sigara içmek

The Relationship Between The Lumbar Disc Degeneration And Smoking

The purpose of this study was to determine whether smoking was related to lumbar disc degeneration. We included 200 patients at the age of between 15 and 70 years, who presented at the neurosurgery polyclinic for lumbago and had lumbar magnetic resonance images, and who had been diagnosed with herniated lumbar disc; the patients’ histories, complaints, and whether they smoked were recorded. We excluded those with a systemic disease and did not meet the age criteria. Smoking was found to have no effects on degeneration when compared the groups. We concluded that smoking was not a risk factor associated with lumbar disc degeneration.Key words: Intervertebral disc degeneration, lumbar vertebrae, risk factors, smoking.

Keywords:

Intervertebral disc degeneration, lumbar vertebrae, risk factors, smoking,

PDF

___

Zileli M, Gülmen V. Lomber disk hernisinde yakınma ve bulgular. In: Zileli M, Özer AF Eds. Omurilik ve omurga cerrahisi. 2. ed. Izmir, Turkey: Meta Basım ve Matbaacılık Hizmetleri, 2002;635-646.
Antoniou J, Steffen T, Nelson F, et al. The human lumbar intervertebral disc: evidence for changes in the biosynthesis and denaturation of the extracellular matrix with growth, maturation, ageing, and degeneration. J Clin Invest 1996;98:996-1003.
Buckwalter JA. Aging and degeneration of the human intervertebral disc. Spine (Phila Pa 1976) 1995;20:1307-1314.
Heliovaara M, Knekt P, Aromaa A. Incidence and risk factors of herniated lumbar intervertebral disc or sciatica leading to hospitalization. J Chronic Dis 1987;40:251-258.
Kelsey JL. Epidemiology of radiculopathies. Adv Neurol 1978;19:385-398.
Akmal M, Kesani A, Anand B, Singh A, Wiseman M, Goodship A. Effect of nicotine on spinal disc cells: a cellular mechanism for disc degeneration. Spine (Phila Pa 1976) 2004;29:568-575.
Andersson GB. Epidemiologic aspects on low-back pain in industry. Spine (Phila Pa 1976) 1981;6:53-60.
Kim KS, Yoon ST, Park JS, Li J, Park MS, Hutton WC. Inhibition of proteoglycan and type II collagen synthesis of disc nucleus cells by nicotine. J Neurosurg 2003;99:291-297.
Ogawa T, Matsuzaki H, Uei H, Nakajima S, Tokuhashi Y, Esumi M. Alteration of gene expression in intervertebral disc degeneration of passive cigarette- smoking rats: separate quantitation in separated nucleus pulposus and annulus fibrosus. Pathobiology 2005;72:146-151.
Ernst E. [Smoking is a risk factor for spinal diseases. Hypothesis of the pathomechanism]. Wien Klin Wochenschr 1992;104:626-630.
Iatridis JC, Weidenbaum M, Setton LA, Mow VC. Is the nucleus pulposus a solid or a fluid? Mechanical behaviors of the nucleus pulposus of the human intervertebral disc. Spine (Phila Pa 1976) 1996;21:1174-1184.
Miller VM, Clouse WD, Tonnessen BH, et al. Time and dose effect of transdermal nicotine on endothelial function. Am J Physiol Heart Circ Physiol 2000;279:H1913-1921.
Schneiderman G, Flannigan B, Kingston S, Thomas J, Dillin WH, Watkins RG. Magnetic resonance imaging in the diagnosis of disc degeneration: correlation with discography. Spine (Phila Pa 1976) 1987;12:276-281.
Jensen TS, Kjaer P, Korsholm L, et al. Predictors of new vertebral endplate signal (Modic) changes in the general population. Eur Spine J 2010;19:129-135.
Okada E, Matsumoto M, Ichihara D, et al. Aging of the cervical spine in healthy volunteers: a 10-year longitudinal magnetic resonance imaging study. Spine (Phila Pa 1976) 2009;34:706-712.
Kanayama M, Togawa D, Takahashi C, Terai T, Hashimoto T. Cross-sectional magnetic resonance imaging study of lumbar disc degeneration in 200 healthy individuals. J Neurosurg Spine 2009;11:501-507.
Leboeuf-Yde C, Kyvik KO, Bruun NH. Low back pain and lifestyle. Part I: Smoking. Information from a population based sample of 29,424 twins. Spine (Phila Pa 1976) 1998;23:2207-2213; discussion 2214.
Ernst E. Smoking, a cause of back trouble? Br J Rheumatol 1993;32:239-242.
Jayson MI, Keegan A, Million R, Tomlinson I. A fibrinolytic defect in chronic back pain syndromes. Lancet 1984;2:1186-1187.
Corre F, Lellouch J, Schwartz D. Smoking and leucocytecounts. Results of an epidemiological survey. Lancet 1971;2:632-634.
Clark CC, Tolin BS, Brighton CT. The effect of oxygen tension on proteoglycan synthesis and aggregation in mammalian growth plate chondrocytes. J Orthop Res 1991;9:477-484.
Henderson GE, Mason RM. Effect of oxygen tension on 35S-glycosaminoglycan synthesis and UDP-sugar pool size in articular cartilage. Biochem Soc Trans 1991;19:364S.
Terahata N, Ishihara H, Ohshima H, Hirano N, Tsuji H. Effects of axial traction stress on solute transport and proteoglycan synthesis in the porcine intervertebral disc in vitro. Eur Spine J 1994;3:325-330.
Lawson GM, Hurt RD, Dale LC, et al. Application of serum nicotine and plasma cotinine concentrations to assessment of nicotine replacement in light, moderate, and heavy smokers undergoing transdermal therapy. J Clin Pharmacol 1998;38:502-509.
Khan MA, Provenza DV, Olson NO, Overman DO. Nicotine toxicity in chick vertebral chondrocytes in vitro. Chem Biol Interact 1981;35:363-367.
Broulik PD, Jarab J. The effect of chronic nicotine administration on bone mineral content in mice. Horm Metab Res 1993;25:219-221.
Ramp WK, Lenz LG, Galvin RJ. Nicotine inhibits collagen synthesis and alkaline phosphatase activity, but stimulates DNA synthesis in osteoblast-like cells. Proc Soc Exp Biol Med 1991;197:36-43.
Fertig JB, Pomerleau OF, Sanders B. Nicotine-produced antinociception in minimally deprived smokers and exsmokers. Addict Behav 1986;11:239-248.
Yuhara S, Kasagi S, Inoue A, Otsuka E, Hirose S, Hagiwara H. Effects of nicotine on cultured cells suggest that it can influence the formation and resorption of bone. Eur J Pharmacol 1999;383:387-393.
Iatridis JC, Setton LA, Weidenbaum M, Mow VC. Alterations in the mechanical behavior of the human lumbar nucleus pulposus with degeneration and aging. J Orthop Res 1997;15:318-322.