Abstract
STUDY DESIGN.: Retrospective study. OBJECTIVE.: To study the impact of smoking status on postoperative complications and pseudarthrosis in adult patients undergoing posterolateral fusion (PLF) of the lumbar spine. SUMMARY OF BACKGROUND DATA.: Results of studies analyzing the impact of smoking on complication and pseudarthrosis rates after spine surgery are conflicting. METHODS.: A retrospective medical record review was performed to identify all adult patients who underwent single- and 2-level instrumented PLF without interbody devices for degenerative spine disease in a 21-year period at a single institution. Patients were divided into smokers and nonsmokers. The main outcome variables were development of at least one postoperative complication and development of pseudarthrosis. RESULTS.: A total of 281 patients underwent single- or 2-level PLF in the 21-year period. Of these, 231 (82.21%) patients were nonsmokers and 50 (17.9%) were smokers. For patients undergoing single-level PLF, complication rates in nonsmokers (3.57%) versus smokers (7.69%) were not significantly different (P = 0.353); pseudarthrosis in nonsmokers occurred in 9.82% of cases compared with 7.69% in the smokers group (P = 0.738). Nonsmokers undergoing 2-level PLF had complication rates of 6.72%, compared with 4.17% in smokers (P = 0.638), but pseudarthrosis rates were significantly higher in the smokers group than in the nonsmokers group (29.17% vs. 10.92%; P = 0.019). Patients were followed up for an average of 53.5 months. CONCLUSION.: The findings in this study suggest that smoking has a significant impact on pseudarthrosis rates after 2-level PLF of the lumbar spine, but not necessarily on single-level PLF.Level of Evidence: 4.
Original language | English (US) |
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Pages (from-to) | 1765-1770 |
Number of pages | 6 |
Journal | Spine |
Volume | 39 |
Issue number | 21 |
DOIs | |
State | Published - Oct 1 2014 |
Keywords
- complications
- fusion
- lumbar
- outcomes
- posterolateral fusion
- pseudarthrosis
- smoking
- spine
- surgery
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Clinical Neurology