Waterpipe Smoking and Lumbar Intervertebral Disc Degeneration: A Pilot Study

Study DesignRetrospective study.ObjectiveThe objective of this study is to investigate the association of waterpipe smoking with lumbar intervertebral disc degeneration (IVDD).MethodsThis is a retrospective chart review study. A total of 286 adults who underwent a lumbar magnetic resonance imaging (MRI) at a tertiary medical center were included and divided into three groups. Group 1 (n = 125) included non-smokers, group 2 (n = 80) smoked cigarettes only, and group 3 (n = 81) smoked waterpipe only. The intervertebral discs were graded using the Pfirmann disc degeneration grading system.ResultsThe study showed higher lumbar disc degeneration scores for waterpipe and cigarette smokers compared to non-smokers at all spinal levels. Specifically, post hoc analysis showed that there was a significant difference at L1-L2 between cigarette smokers and non-smokers ( P = 0.007) and between waterpipe smokers and non-smokers ( P = 0.013), and a significant difference at L3-L4 and L4-L5 between non-smokers and cigarettes smokers ( P < .001 and P = .029 respectively).ConclusionWaterpipe smoking is associated with lumbar intervertebral disc degeneration.