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Posted on Sun, 30 Jul 2017 in Brain and Spine
Question: Can I develop 4.5mm compression on C4-C7 from smoking? I am 46 and had a significant trip and fall, which required 6 surgeries, one of which was a 4-Level Cervical Fusion. We are trying to tie that compression to my trip and fall in April 2013 and symptoms of the stenosis showed up in October 2013 with my right hand and forearm going numb and tingling. Can you please tell me, in your medical experience if it is because I smoke, or is not possible? And if not, would a trip and fall cause, if not exacerbated, whatever pre-existing and normal compression from wear and tear and my age.
Answered by Dr. Antoneta Zotaj 7 hours later
Brief Answer:
There is an indirect relation of smoking with bone compression

Detailed Answer:
Thank you from asking at healthcaremagic.

I carefully read your question and understand your concern. By what i read you have had a compression of the vertebra which in itself is a compression fracture (fracture where the body of the vertebra is crushed). There are several factors that put the patients in risk for these fractures.

Generally trauma might cause fractures especially in the vertebral bodies as it might have happened in your case. There are other factors that predispose the fractures spontaneous or the ones after trauma.

One is the "density" of the bone which if it is low we call it ostheoporosis. In this case less calcium is in the bones making them easier to fracture. Being a female is a risk factor for ostheoporisis. Age and menopause predispose ostheoporosis also especially if you had your last periods earlier than 5-10 years ago.

Smoking is another factor that indirectly might affect the mineralization of the bones and favor ostheoporosis to happen by increasing the risks for fracture of the bones. So there is an indirect connection of smoking with bone fractures due to affect it has on bone mineralization.

Low diet calcium, poor diets, some medications like the steroids or medications taken for acid reflux, sedentary life, alcohol use and as mentioned above smoking, are factors that predispose ostheoporosis but good new is that they can be modified (we can do things to prevent those).

So to conclude I would say:
1. there is no direct connection of smoking with bone fractures but smoking indirectly increases risks for fractures by favoring ostheoporosis (bone thinning)
2. there is never late to stop smoking- I would advise you to quit smoking due to the above reasons but also the other health risks it has
3. other measures that might help are those related to modifiable factors mentioned above: being more active (watch that you do not increase risks of falls), stop alcohol use if you are using it, avoid over the counter antiacid medications, talk with your doctor if you are taking steroids, have a diet rich in calcium (you need 3 portions of milk products a day like cheese, yogurt and milk).
4. I would recommend you to have a test to check the density of your bones. it is called DEXA scan of the bones and tests the bone density of the thigh bone and the one of the vertebra. This will help diagnose ostheoporosis and also monitor it
5. If ostheoporosis is found than you will need specific treatments for ostheoporosis called alendronate that helps deposit calcium in the bones
6. if there is no ostheoporosis than this is a great news and the compression is purely related to the trauma, in this case still the preventive measures mentioned above are advisable as you are at risk of ostheoprosis being a female and advancing in age.

I hope this is helpful and answers to your question but please feel free to write me in case anymore clarifications are needed.

Kind regards,

Antoneta Zotaj, MD
Above answer was peer-reviewed by : Dr. Raju A.T
Follow up: Dr. Antoneta Zotaj 2 hours later
Hey Dr. Zotaj. I did not have a cervical fracture. I had 4.5mm compression of my spinal cord at C4-C7. I tripped and fell in 2013 and stenosis symptoms showed up within months of falling, like whiplash. I am tyring to find medical proof that smoking for 25 years would not cause that severe compression on my cervical spine. Can you please tell me that smoking cigarettes would nevre caues 4.5mm compression on 4 levels? Does 4.5mm compression on C4-C7 imply there was some sort of trauma...if i am telling you I had a trip and fall incident.
Answered by Dr. Antoneta Zotaj 8 hours later
Brief Answer:
Smoking is possibly less likely a direct cause in your case but is still a risk factor

Detailed Answer:
Hello again,

Thank you for the reply and explanations. I went through it carefully.

In medical terms compression of the vertebras is otherwise called compression fracture, it is in itself a fracture that causes the vertebral bodies to compress and loose their rectangle shape. Bones are hard structures, they don't compress unless a fracture happens in there. It is very common to get compression fractures in the verterbras especially the neck and low back ones which are also the parts of the spine we move the most and are more affected by trauma.

At your age bone compression due to osteoporosis is more rare, it would be more common after 60 years old or at least after 5-10 years in menopause so very likely the compression you have is due to some trauma you might have had and very little chance to be from osteoporosis.

Still smoking remains a risk factor for bone compression due to bone thinning it can cause. I can not say that smoking never increases the risk for compression in the spine but you are in time to do some healthy lifestyle changes and smoking now will definitely be a help to prevent further compression.

When a condition happens most of the times it is difficult to know exactly what was the main cause of it, especially if several causes are possible, but we can know the factors that favor that condition and modify them to prevent further damage.

Please feel free to ask if anymore clarification is needed on this.

Kind regards,

Antoneta Zotaj, MD

Above answer was peer-reviewed by : Dr. Kampana
Answered by
Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 4352 Questions


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