The Effect of Smoking on Spinal Cord Healing Following Surgical Treatment of Cervical XXXX .

@entity1 @entity6 @entity602 @entity2072 @entity3799 @entity1068
STUDY DESIGN: Retrospective cohort. OBJECTIVE: The purpose of this study was to compare outcomes of surgical treatment of @entity3799 between smokers and nonsmokers as assessed by the Nurick score. SUMMARY OF BACKGROUND DATA: The harmful effects of smoking on healing have been well established. However, the effect of smoking on postoperative outcomes for @entity3799 has not been specifically evaluated. METHODS: The medical records of 212 @entity1 who underwent surgery for cervical @entity602 were reviewed. Inclusion criteria were the diagnosis of cervical @entity602 with a Nurick score, surgical intervention, and at least 2 years of follow-up. The @entity1 were categorized into 2 groups according to smoking status and stratified according to pack years and packs per day. Age at presentation, sex, preoperative and postoperative Nurick score, duration of symptoms preoperatively, duration of follow-up, procedure performed, surgical approach, number of levels fused, @entity6 status, @entity2072 use, @entity1068 use, preoperative magnetic resonance imaging signal change, and whether the @entity1 belonged to the Veterans Administration (VA) were recorded. Analysis was done using simple linear regression and multiple regression. RESULTS: Univariate analysis demonstrated a postoperative improvement in nonsmokers of 1.53 points on the Nurick scale compared with 0.6 points in smokers (P < 0.001). There is a progressive decrease in improvement as the number of pack years and packs per day increase (P < 0.001). There is a greater improvement in Nurick score with greater (worse) preoperative score but only in @entity1 with fewer than 25 pack years. Smoking status is not associated with preoperative Nurick score. CONCLUSION: Smoking status is associated with poor improvement in Nurick score after surgical treatment of @entity3799 . Smoking may have a directly toxic effect on the intrinsic healing capability of the spinal cord, particularly beyond 25 pack years. LEVEL OF EVIDENCE: 3.
