A presentation at the 2015 Congress of Neurological Surgeons Annual Meeting
NEW ORLEANS, La., September 27, 2015— Winner of the Sam Hassenbusch Young Neurosurgeon Award Raul A. Vasquez-Castellanos, presented results from The Profile of a Smoker and Its Impact on Outcomes after Cervical Spine Surgery during the Original Science Program at the 2015 CNS Annual Meeting.
Many of the negative health effects of smoking have been well documented and publicized—various cancers, chronic respiratory disease, and heart disease, as well as premature death, are all consequences from smoking cigarettes. Today, with the current focus on decreasing costs and complications while improving patient outcomes after surgery, attention has turned to acting on modifiable patient characteristics before surgery—such as smoking. Further, the impact of smoking on the recovery outcomes of degenerative cervical spine surgery is not well understood.
A one-year study was held with 473 patients that had cervical degeneration and who were enrolled in a prospective longitudinal registry to better understand the role of smoking in recovery outcomes after cervical spine surgery. At the initial evaluation, 123 (26 percent) of the patients were smokers and 350 (74 percent) were not. The smoking population was younger (51 vs 56 years old, P < .001) and also had a higher use of narcotics.
At the baseline and 12-month follow-up, smokers had significantly higher arm and neck pain scores, and NDI (Neck Disability Index percentages), and lower EQ-5D (European Quality of Life-5 Dimensions) scores. At the 12-month follow up, smokers had less improvement in neck pain, NDI percentages, mJOAS, and SF-12 PCS (Short Form-12 Health Survey from patient’s point of view).
The smoking population reported lower satisfaction scores, with 24 percent of smokers having unfulfilled expectations one year after their surgery versus 14 percent in the nonsmokers group. Results conclusively showed that smoking resulted in lower absolute scores and less benefit from cervical spine surgery compared with nonsmokers, even after controlling for confounding variables. Quitting smoking should be strongly considered before cervical spine surgery to optimize the outcome of surgery.
Author Block: Raul A. Vasquez-Castellanos, MD; Silky Chotai, MD; Joseph Wick; David P. Stonko; Joseph S. Cheng, MD, MS; Devin, Clinton J. MD; Anthony L. Asher, MD, FACS; Matthew J. McGirt, MD
The author reported no conflicts of interest.
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