Department of Spine Surgery, Shanghai East Hospital, Tongji University, 150 Jimo Rd., Shanghai 200120, China.
Department of Spine Surgery, Shanghai East Hospital, Tongji University, 150 Jimo Rd., Shanghai 200120, China.
Int J Surg. 2018 May;53:269-273. doi: 10.1016/j.ijsu.2018.04.004. Epub 2018 Apr 9.
To investigate cigarette smoking's relevance with cervical disc degeneration.
We randomly selected 320 patients who came to our spine disease department outpatient clinic with chief complaint of neck-shoulder pain during June 2014-June 2016. According to the detailed smoking history, these patients were divided into 3 different groups, which were active smoker group (AS), passive smoking group (PS) and never-smoker group (NS). Each patient's Miyazaki's magnetic resonance imaging (MRI) classification of cervical disc degeneration was analyzed based on their cervical MRI films. In addition, VAS scores were applied to evaluate the degree of patients' neck-shoulder pain. With the help of statistical techniques, relevance between cigarette smoking, cervical disc degeneration and neck-shoulder pain were analyzed.
In the NS group, the overall Miyazaki score, especially for C2/3, C3/4, C5,6 segments, are superior to those in the PS group, in addition, the Miyazaki scores for C1/2 - C6/7 segments in NS group beat the same segments in AS group with statistical significance (P < 0.05). In the AS and PS group, discs from C4/5 to C5/6 segments which score IV and V on Miyazaki classification account for a larger proportion than those discs from C1/2 to C3/4 segments with statistical significance (P < 0.05). In the AS group, male cases have larger proportion of Miyazaki level IV and V discs than female with statistical significance (P < 0.05). While in the AS and PS group, Miyazaki scores of patients whose smoking history ranges from 5 to 10 years are superior to those with smoking history longer than 10 years, with statistical significance (P < 0.05). In addition, VAS scores also vary among the three groups, in which, VAS scores in AS group are higher than those in the NS group.
Smoking could accelerate the process of cervical disc degeneration, presenting with more severe neck-shoulder pain on the patients. In addition, the impact of smoking on the lower cervical discs is greater than the upper cervical discs.
探讨吸烟与颈椎间盘退变的相关性。
我们随机选取了 2014 年 6 月至 2016 年 6 月期间因颈肩部疼痛就诊于我院脊柱疾病科门诊的 320 例患者。根据详细的吸烟史，将这些患者分为三组：主动吸烟者组（AS）、被动吸烟者组（PS）和非吸烟者组（NS）。根据颈椎 MRI 片分析每位患者的颈椎间盘退变的 Miyazaki 磁共振成像（MRI）分类。此外，采用视觉模拟评分（VAS）评估患者颈肩部疼痛程度。利用统计技术分析吸烟与颈椎间盘退变及颈肩部疼痛的相关性。
在 NS 组中，C2/3、C3/4、C5、6 节段的总体 Miyazaki 评分，尤其是 C2/3、C3/4、C5、6 节段的 Miyazaki 评分均优于 PS 组，C1/2-C6/7 节段的 Miyazaki 评分也明显优于 AS 组（P<0.05）。在 AS 和 PS 组中，Miyazaki 分级为 IV 和 V 的 C4/5-C5/6 节段椎间盘的比例大于 C1/2-C3/4 节段椎间盘，差异有统计学意义（P<0.05）。在 AS 组中，男性病例 Miyazaki 分级为 IV 和 V 的椎间盘比例大于女性，差异有统计学意义（P<0.05）。而在 AS 和 PS 组中，吸烟史 5-10 年的患者 Miyazaki 评分优于吸烟史>10 年的患者，差异有统计学意义（P<0.05）。此外，三组间 VAS 评分也存在差异，其中 AS 组的 VAS 评分高于 NS 组。
吸烟可加速颈椎间盘退变过程，使患者出现更严重的颈肩部疼痛。此外，吸烟对下颈椎间盘的影响大于上颈椎间盘。
