Abstract

Study Design Retrospective study. Objective The objective of this study is to investigate the association of waterpipe smoking with lumbar intervertebral disc degeneration (IVDD). Methods This 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. Results The 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). Conclusion Waterpipe smoking is associated with lumbar intervertebral disc degeneration.