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

Jackson, Keith L.; DeVine, John G.

doi:10.1055/s-0036-1571285

Cited by 111 publications

(68 citation statements)

References 72 publications

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“…These results are consistent with previously published data describing a significant negative association between smoking and spine surgery outcomes. 52 …”

Section: Discussionmentioning

confidence: 99%

Predictors of Outcome in Conservative and Minimally Invasive Surgical Management of Pain Originating From the Sacroiliac Joint

Dengler

Duhon

Whang

et al. 2017

Spine

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Study Design.A pooled patient-level analysis of two multicenter randomized controlled trials and one multicenter single-arm prospective trial.Objective.The aim of this study was to identify predictors of outcome of conservative and minimally invasive surgical management of pain originating from the sacroiliac joint (SIJ).Summary of Background Data.Three recently published prospective trials have shown that minimally invasive SIJ fusion (SIJF) using triangular titanium implants produces better outcomes than conservative management for patients with pain originating from the SIJ. Due to limitations in individual trial sample size, analyses of predictors of treatment outcome were not conducted.Methods.We pooled individual patient data from the three trials and used random effects models with multivariate regression analysis to identify predictors for treatment outcome separately for conservative and minimally invasive surgical treatment. Outcome was measured using visual analogue scale (VAS), Oswestry Disability Index (ODI), and EuroQOL-5D (EQ-5D).Results.We included 423 patients assigned to either nonsurgical management (NSM, n = 97) or SIJF (n = 326) between 2013 and 2015. The reduction in SIJ pain was 37.9 points larger [95% confidence interval (95% CI) 32.5–43.4, P < 0.0001] in the SIJF group than in the NSM group. Similarly, the improvement in ODI was 18.3 points larger (95% CI 14.3–22.4), P < 0.0001). In NSM, we found no predictors of outcome. In SIJF, a reduced improvement in outcome was predicted by smoking (P = 0.030), opioid use (P = 0.017), lower patient age (P = 0.008), and lower duration of SIJ pain (P = 0.028).Conclusions.Our results support the view that SIJF leads to better treatment outcome than conservative management of SIJ pain and that a higher margin of improvement can be predicted in nonsmokers, nonopioid users, and patients of increased age and with longer pain duration.Level of Evidence: 1

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“…These results are consistent with previously published data describing a significant negative association between smoking and spine surgery outcomes. 52 …”

Section: Discussionmentioning

confidence: 99%

Predictors of Outcome in Conservative and Minimally Invasive Surgical Management of Pain Originating From the Sacroiliac Joint

Dengler

Duhon

Whang

et al. 2017

Spine

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“… 13 Other studies showed preoperative smoking cessation for 4 weeks is associated with a decreased risk of infection, perioperative respiratory, and wound complications. 14 - 16 Thus, it would be necessary to refrain from smoking at least 4 weeks before surgery and 6 months after surgery.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Patient Satisfaction After Decompression Surgery Without Fusion for Lumbar Spinal Stenosis

Ogura

Kobayashi

Shinozaki

et al. 2019

Global Spine Journal

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Study Design: Retrospective cohort study. Objectives: Decompression without fusion is a standard surgical treatment for lumbar spinal stenosis (LSS) with reasonable surgical outcomes. Nevertheless, some studies have reported low patient satisfaction (PS) following decompression surgery. The cause of the discrepancy between reasonable clinical outcomes and PS is unknown; moreover, the factors associated with PS are expected to be complex, and little is known about them. This study aimed to identify satisfaction rate and to clarify the factors related to PS following decompression surgery in LSS patients. Methods: We retrospectively reviewed 126 patients who underwent lumbar decompression with a minimum follow-up of 1 year. Patients were divided into 2 groups based on the PS question. The Japanese Orthopaedic Association (JOA) scores, and the Numeric Rating Scale (NRS) scores of low back pain (LBP), leg pain, and leg numbness were compared between the 2 groups preoperatively and at the latest visit. To identify the prognostic factors for dissatisfaction, multiple logistic regression analysis was performed. Results: Overall satisfaction rate was 75%. The JOA recovery rate, NRS improvement, and Short Form–8 (SF-8) were significantly higher in the satisfied group. Postoperative NRS scores of LBP, leg pain, and leg numbness were significantly lower in the satisfied group. Multivariate logistic regression analysis showed that smoking and scoliosis were significant risk factors for dissatisfaction. Conclusions: Overall satisfaction rate was 75% in patients with LSS undergoing decompression surgery. This study found that smoking status and scoliosis were associated with patient dissatisfaction following decompression in LSS patients.

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“…Younger age, non-smoking status, high preoperative NDI score, and low postoperative NRS score for the arm were observed to be significantly different in those who were subjectively satisfied. A systematic review showed that the effectiveness of cervical and lumbar surgery in smokers is lower than that in non-smokers [ 18 ]. Our results were consistent with these findings.…”

Section: Discussionmentioning

confidence: 99%

Factors related to subjective satisfaction following microendoscopic foraminotomy for cervical radiculopathy

Tonosu

Inanami²,

Oka

et al. 2018

BMC Musculoskelet Disord

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BackgroundMicroendoscopic foraminotomy has been reported to be effective for the treatment of cervical radiculopathy, using outcome measurement scores such as the neck disability index (NDI) and numerical rating scale (NRS). However, the scores for spine surgery do not always reflect the true subjective satisfaction of the patient. The purpose of this study was to evaluate factors related to subjective satisfaction following microendoscopic foraminotomy for cervical radiculopathy.MethodsThe subjects consisted of consecutive patients who underwent microendoscopic foraminotomy for cervical radiculopathy. Patient background information and operative data were collected. The NDI, the NRS score for the neck, upper back, and arm, and the EuroQOL-5D (EQ-5D) were assessed preoperatively and 1 year postoperatively. Postoperative subjective satisfaction was also assessed as a direct evaluation of satisfaction, and willingness to undergo the same operation if needed was assessed as an indirect evaluation.ResultsA total of 42 patients were included in this study. The mean age was 52.9 ± 11.8 years; 19.0% were female and 81.0% were male. The operation time for one level was 57.7 min and the estimated blood loss was minimal in most cases. All NDI, NRS, and EQ-5D scores improved significantly postoperatively. Univariate analyses revealed that the factors related to subjective satisfaction were younger age, non-smoking status, high preoperative NDI score, and low postoperative NRS score for the arm. Factors related to the willingness to undergo the same operation if needed were high preoperative NDI scores, high preoperative NRS scores for the arm, and low preoperative EQ-5D scores.ConclusionsFactors related to subjective satisfaction following microendoscopic foraminotomy include younger age, non-smoking status, high preoperative NDI score, high preoperative NRS score for the arm, low preoperative EQ-5D score, and a low postoperative NRS score for the arm.

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

Cited by 111 publications

References 72 publications

Predictors of Outcome in Conservative and Minimally Invasive Surgical Management of Pain Originating From the Sacroiliac Joint

Predictors of Outcome in Conservative and Minimally Invasive Surgical Management of Pain Originating From the Sacroiliac Joint

Factors Influencing Patient Satisfaction After Decompression Surgery Without Fusion for Lumbar Spinal Stenosis

Factors related to subjective satisfaction following microendoscopic foraminotomy for cervical radiculopathy

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