Magnetic resonance imaging evaluation of the effects of cigarette and maras powder (smokeless tobacco) on lumbar disc degeneration.

The main aim of this study was to investigate and compare the effects of the use of Maras powder and cigarettes on lumbar disc degeneration.This study included 87 adult patients who presented at our hospital with a complaint of mechanical low back pain and underwent lumbar magnetic resonance imaging (MRI). Patients meeting the inclusion criteria were divided into three groups. Group 1 included those who smoked Maras powder but not cigarettes, group 2 was comprised of those who smoked cigarettes but did not use Maras powder, and group 3 was comprised of those who did not use tobacco (no cigarettes or Maras powder) (control group). Lumbar disc degeneration was rated according to the Pfirrmann classification. Hematological parameters were obtained from all three groups.Degeneration levels in group 1 were significant when compared to the other groups at all disc levels. Maras powder contributed to intervertebral disc degeneration and this effect increased gradually towards the distal area. The neutrophil to lymphocyte ratio was significantly higher in group 1 than in the other two groups, and was positively correlated with the duration of use of Maras powder (r = 0.689, p ≤ 0.001).Although more prevalent in the Maras powder group, lumbar disc degeneration increased significantly with tobacco usage. The results of our study show that Maras powder, commonly used regionally, is likely to cause more spinal disc degeneration than cigarettes.