The Effects of Smoking and Smoking Cessation on Spine Surgery: A Systematic Review of the Literature

Overview

Journal Global Spine J

Publisher Sage Publications

Date 2016 Oct 27

PMID 27781190

Citations 41

Authors

Keith L Jackson 2nd

John G DeVine

Affiliations

Soon will be listed here.

Abstract

Literature review. The aim of this literature review was to detail the effects of smoking in spine surgery and examine whether perioperative smoking cessation could mitigate these risks. A review of the relevant literature examining the effects of smoking and cessation on surgery was conducted using PubMed, Google Scholar, and Cochrane databases. Current smokers are significantly more likely to experience pseudarthrosis and postoperative infection and to report lower clinical outcomes after surgery in both the cervical and lumbar spines. Smoking cessation can reduce the risks of these complications depending on both the duration and timing of tobacco abstinence. Smoking negatively affects both the objective and subjective outcomes of surgery in the lumbar and cervical spine. Current literature supports smoking cessation as an effective tool in potentially mitigating these unwanted outcomes. Future investigations in this field should be directed toward developing a better understanding of the complex relationship between smoking and poorer outcomes in spine surgery as well as developing more efficacious cessation strategies.

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References

BRODSKY A, Khalil M, Sassard W, Newman B . Repair of symptomatic pseudoarthrosis of anterior cervical fusion. Posterior versus anterior repair. Spine (Phila Pa 1976). 1992; 17(10):1137-43. DOI: 10.1097/00007632-199210000-00002. View

Schimmel J, Horsting P, De Kleuver M, Wonders G, van Limbeek J . Risk factors for deep surgical site infections after spinal fusion. Eur Spine J. 2010; 19(10):1711-9. PMC: 2989231. DOI: 10.1007/s00586-010-1421-y. View

Mooney V, McDermott K, Song J . Effects of smoking and maturation on long-term maintenance of lumbar spinal fusion success. J Spinal Disord. 1999; 12(5):380-5. View

Lee J, Lee S, Peters C, Riew K . Risk-factor analysis of adjacent-segment pathology requiring surgery following anterior, posterior, fusion, and nonfusion cervical spine operations: survivorship analysis of 1358 patients. J Bone Joint Surg Am. 2014; 96(21):1761-7. DOI: 10.2106/JBJS.M.01482. View

Miwa S, Yokogawa A, Kobayashi T, Nishimura T, Igarashi K, Inatani H . Risk factors of recurrent lumbar disk herniation: a single center study and review of the literature. J Spinal Disord Tech. 2012; 28(5):E265-9. DOI: 10.1097/BSD.0b013e31828215b3. View

Bydon M, Macki M, de la Garza-Ramos R, Sciubba D, Wolinsky J, Ziya L Gokaslan . Smoking as an independent predictor of reoperation after lumbar laminectomy: a study of 500 cases. J Neurosurg Spine. 2015; 22(3):288-93. DOI: 10.3171/2014.10.SPINE14186. View

Eubanks J, Thorpe S, Cheruvu V, Braly B, Kang J . Does smoking influence fusion rates in posterior cervical arthrodesis with lateral mass instrumentation?. Clin Orthop Relat Res. 2010; 469(3):696-701. PMC: 3032837. DOI: 10.1007/s11999-010-1575-2. View

Tetreault L, Kopjar B, Vaccaro A, Yoon S, Arnold P, Massicotte E . A clinical prediction model to determine outcomes in patients with cervical spondylotic myelopathy undergoing surgical treatment: data from the prospective, multi-center AOSpine North America study. J Bone Joint Surg Am. 2013; 95(18):1659-66. DOI: 10.2106/JBJS.L.01323. View

Hadley M, Reddy S . Smoking and the human vertebral column: a review of the impact of cigarette use on vertebral bone metabolism and spinal fusion. Neurosurgery. 1997; 41(1):116-24. DOI: 10.1097/00006123-199707000-00025. View

10.

Gulati S, Nordseth T, Nerland U, Gulati M, Weber C, Giannadakis C . Does daily tobacco smoking affect outcomes after microdecompression for degenerative central lumbar spinal stenosis? - A multicenter observational registry-based study. Acta Neurochir (Wien). 2015; 157(7):1157-64. DOI: 10.1007/s00701-015-2437-1. View

11.

Cobo Soriano J, Sendino Revuelta M, Fuente M, Cimarra Diaz I, Martinez Urena P, Deglane Meneses R . Predictors of outcome after decompressive lumbar surgery and instrumented posterolateral fusion. Eur Spine J. 2010; 19(11):1841-8. PMC: 2989260. DOI: 10.1007/s00586-010-1284-2. View

12.

Bydon M, de la Garza-Ramos R, Abt N, Ziya L Gokaslan , Wolinsky J, Sciubba D . Impact of smoking on complication and pseudarthrosis rates after single- and 2-level posterolateral fusion of the lumbar spine. Spine (Phila Pa 1976). 2014; 39(21):1765-70. DOI: 10.1097/BRS.0000000000000527. View

13.

Agaku I, King B, Dube S . Current cigarette smoking among adults - United States, 2005-2012. MMWR Morb Mortal Wkly Rep. 2014; 63(2):29-34. PMC: 4584648. View

14.

Hilibrand A, Fye M, Emery S, Palumbo M, Bohlman H . Impact of smoking on the outcome of anterior cervical arthrodesis with interbody or strut-grafting. J Bone Joint Surg Am. 2001; 83(5):668-73. DOI: 10.2106/00004623-200105000-00004. View

15.

Whitesides Jr T, Hanley Jr E, Fellrath Jr R . Smoking abstinence. Is it necessary before spinal fusion?. Spine (Phila Pa 1976). 1994; 19(17):2012-4. View

16.

BISHOP R, Moore K, Hadley M . Anterior cervical interbody fusion using autogeneic and allogeneic bone graft substrate: a prospective comparative analysis. J Neurosurg. 1996; 85(2):206-10. DOI: 10.3171/jns.1996.85.2.0206. View

17.

Soni A, Vollans S, Malhotra K, Mann C . Association Between Smoking and Wound Infection Rates Following Calcaneal Fracture Fixation. Foot Ankle Spec. 2014; 7(4):266-270. DOI: 10.1177/1938640014537301. View

18.

Luszczyk M, Smith J, Fischgrund J, Ludwig S, Sasso R, Shaffrey C . Does smoking have an impact on fusion rate in single-level anterior cervical discectomy and fusion with allograft and rigid plate fixation? Clinical article. J Neurosurg Spine. 2013; 19(5):527-31. DOI: 10.3171/2013.7.SPINE13208. View

19.

Vogt M, Hanscom B, Lauerman W, Kang J . Influence of smoking on the health status of spinal patients: the National Spine Network database. Spine (Phila Pa 1976). 2002; 27(3):313-9. DOI: 10.1097/00007632-200202010-00022. View

20.

Mok J, Cloyd J, Bradford D, Hu S, Deviren V, Smith J . Reoperation after primary fusion for adult spinal deformity: rate, reason, and timing. Spine (Phila Pa 1976). 2009; 34(8):832-9. DOI: 10.1097/BRS.0b013e31819f2080. View