Artikel
Short- and long-term effects of smoking on pain and health-related quality of life after non-instrumented lumbar spine surgery
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Veröffentlicht: | 8. Juni 2016 |
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Gliederung
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Objective: A myriad of negative bodily health effects related to tobacco smoking is known while its detrimental effects on the spine in particular are less defined.
Method: Prospective observational study on n=172 consecutive patients undergoing non-instrumented spine surgery for lumbar disc herniation (LDH) or lumbar spinal stenosis (LSS) with a maximum follow-up (FU) of 4.5-years. Patients were dichotomized according to their smoking status. Back pain and health-related quality of life (HRQoL) were assessed using the visual analogue scale (VAS) and the short-form (SF)-12. Any subsequent lumbar spine surgeries since the index surgery were registered. Logistic regression analysis was used to estimate the effect size of the relationship between smoking and the responder status to surgery in terms of pain and HRQoL-metrics.
Results: Complete FU data was available for n=29 (55%) smokers and n=73 (61%) non-smokers. At discharge, 1 month, 1 year and 4.5 years, smokers at the time of surgery were as likely as non-smokers to achieve a favourable response to surgery in terms of VAS back pain and the SF-12 mental- and physical component scale metric. Also, a subgroup analysis on active smokers throughout the entire study interval did not find an inferior responder rate to surgery to non-smokers. A trend for additional lumbar spine surgery performed in 17.2% of the smoking and 8.2% of the non-smoking patients during FU was observed (OR 2.39, 95% CI 0.67-8.57, p=0.179).
Conclusions: Up to 4.5 years following non-instrumented lumbar spine surgery, there was no difference in the pain- or HRQoL-responder status of smokers and non-smokers. Smokers may be more likely to undergo re-do surgery in the long-term, but more data is needed to confirm this statistical trend.