Lightning Podiums: Spinal Potpourri - 803B

Presented by: P. Tamer

Author(s):

P. Tamer(1), J. Du(2), K. Goon(1), U. Ahn(3), N. Ahn(2)

(1) Case Western Reserve University, School of Medicine, Cleveland, OH, United States
(2) University Hospitals, Department of Orthopedics, Cleveland, OH, United States
(3) New Hampshire Spine Institute, Bedford, OH, United States

Abstract

Introduction: Cigarette smoking has been associated with musculoskeletal burden and functional impairment, including decreased bone mineral density, lumbar disk disease, and increased risk of perioperative and healing complications. Prolonged smoking has been associated with lumbar radicular pain and clinically-verified sciatica. However, there is a paucity of literature evaluating the longitudinal association between musculoskeletal pathology and smoking. We sought to further explore the association between the development of smoking and development of musculoskeletal pathology through the MIDUS longitudinal series.

Methods: Data was utilized from the MIDUS national study, a longitudinal study assessing health and well-being. MIDUS 1 was conducted in 1995-1996 through random dialing sample of English-speaking, non-institutionalized adults in the U.S. There were 7108 participants who completed the MIDUS 1 survey either by telephone or mail. MIDUS 2 was conducted 9-10 years later, with 4963 participants who were successfully contacted to complete the survey. Three separate outcomes were assessed. Patients were asked to respond to whether they had: 1) experienced or been treated for arthritis, rheumatism, or other bone or joint diseases; 2) experienced or been treated for sciatica, lumbago, or recurrent backache; and 3) in the past 30 days taken prescription medicine for arthritis? Patient who denied musculoskeletal pathology and smoking in the MIDUS 1 survey were included. Evaluating these variables, we conducted two-tailed student's t-tests and chi-square tests to compare demographic data as appropriate and McNemar's tests to assess smoking association with musculoskeletal burden.

Results: Of the 4963 participants who completed both MIDUS 1 and MIDUS 2 surveys, there were 2320 participants with a valid response (yes or no) to the question "Do you smoke regularly NOW?" in both surveys (47%). Of these 2320 participants, there were 1362 participants who did not smoke in the MIDUS 1 survey. 839 out of 1362 participants answered the question to bone and joint disease; smokers had a higher incidence of bone and joint disease (19.7% vs. 18.9%, p< 0.001). 858 out of 1362 participants answered the question to back pain; smokers had a higher incidence of back pain (21.8% vs. 12.3%, p< .001). 759 out of 1362 participants answered the question to use of prescription arthritis medication; smokers had a lower incidence of use of arthritis medication (12.7% vs. 17.6%, p< .001).

Discussion: Our findings suggest a positive association between the development of smoking and the development of musculoskeletal morbidity, including arthritis, rheumatism, lumbago, and sciatica. Our findings also show a negative association between development of smoking and the development of use of arthritis medication. Our findings suggest that prevention and intervention in smoking may have implications on musculoskeletal burden.