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Research

Smokers Fare Worse Than Nonsmokers After Spine Surgery

Along with its many other harmful effects, smoking cigarettes appears to adversely affect the outcomes and total costs of patients who undergo surgery for spinal disease.

University of Utah School of Medicine researchers looked at the de-identified records of 122,608 non-smokers and 13,903 smokers treated in hospitals belonging to the University HealthSystem Consortium (UHC). The study looked at patients in the four largest diagnostic groups: fracture, dorsopathy (deviation from or interruption of the normal structure or function of the spine), congenital spine disease and spinal curvature. Outcomes were based on five categories—length of stay; ICU admissions; hospital readmissions, complications and total cost.

The researchers found that compared to nonsmokers patients who smoke tobacco had longer hospital stays, higher admission rates to ICUs, higher hospital readmission rates, more complications and worse outcomes in three of the four diagnostic groups—fracture, spinal dorsopathy and spinal curvature. Smoking patients also had higher total hospital costs than non-smokers in all groups, with increases of 23 percent and 36 percent, respectively, among smokers in the two largest diagnostic groups, dorsopathy and fractures. Outcomes across all categories on those two groups were worse among smokers. 

While more studies are needed to better define the association between smoking tobacco and worse outcomes in spine surgery patients, the authors advise surgeons to encourage spine surgery patients to enroll in formal smoking cessation programs before undergoing an operation.

Meic H. SchmidtNeurosurgery