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- Title
Recidivism Rates After Smoking Cessation Before Spinal Fusion.
- Authors
CARLSON, BRANDON B.; BURTON, DOUGLAS C.; SEAN JACKSON, R.; ROBINSON, STEPHANIE; Jackson, R Sean
- Abstract
Tobacco use has documented negative effects on perioperative complications and clinical outcomes. Smoking cessation before spinal surgery may improve clinical outcomes. The goal of this study was to determine the recidivism rate after smoking cessation before spinal fusion. A prospective observational study was performed at the University of Kansas Medical Center between 2006 and 2011. All patients with serum-confirmed nicotine cessation before spinal fusion surgery were eligible. Smoking status was determined with questionnaires at 3 months, 6 months, and 1 year postoperatively. All reported nonsmokers had confirmatory serum nicotine and cotinine tests. Two-tailed Pearson chi-square and independent t tests were conducted, and significance was set at α=0.05. A total of 42 subjects (21 women, 21 men) with confirmed preoperative serum-negative test results were prospectively enrolled over a period of 3.9 years. Of these patients, 1 opted out at 6 months and 1 died of unknown cause. The findings showed a recidivism rate (response rate) of 60% (40 of 41) at 3 months, 61% (33 of 41) at 6 months, and 68% (25 of 40) at 1 year. One case of asymptomatic pseudarthrosis occurred 1 year postoperatively in a confirmed nonsmoker. No correlation was found between smoking status at 3 months and sex, primary vs revision surgery, or complications (P>.05). Smokers who relapsed at 3 months were older than nonsmokers (55.2 vs 44.2 years, respectively; P=.03). Some patients are willing to cease smoking before spinal fusion for optimal clinical outcomes; however, the rate of recidivism is high (60%) within the first 3 months post-operatively.
- Subjects
SUBSTANCE abuse diagnosis; LONGITUDINAL method; SPINE diseases; PSEUDARTHROSIS; SMOKING; SMOKING cessation; SPINAL fusion; DISEASE relapse
- Publication
Orthopedics, 2016, Vol 39, Issue 2, pe318
- ISSN
0147-7447
- Publication type
journal article
- DOI
10.3928/01477447-20160301-03