吸烟对脊柱及脊柱手术的不良影响。
Adverse impact of smoking on the spine and spinal surgery.
作者信息
Khurana Vini G
机构信息
CNS Neurosurgery, Woolloomooloo, New South Wales, Australia.
出版信息
Surg Neurol Int. 2021 Mar 24;12:118. doi: 10.25259/SNI_6_2021. eCollection 2021.
BACKGROUND
Tobacco smokers and companies are well aware that smoking increases the risks for cancers, vascular morbidity, and early mortality. This is a review of the plethora of adverse effects chronic smoking has on spinal tissues and spinal surgery.
METHODS
Medline (PubMed) and Google Scholar databases were searched for pertinent literature through keywords related to smoking, spondylosis, and spinal surgery.
RESULTS
Smoking accelerates spondylosis by impairing spinal tissue vascular supply through atherosclerosis and thrombosis, while inducing local hypoxia, inflammation, proteolysis, and cell loss. It, thus, compromises disc, cartilage, synovium, bone, and blood vessels. It can lead to early surgery, delayed wound healing, increased surgical site infection, failed fusion, more re-operations, and chronic spinal pain.
CONCLUSION
There is ample evidence to support surgeons' declining to operate on chronic smokers. The need for immediate and permanent smoking cessation and its potential benefits should be emphasized for the patient considering or who has undergone spinal surgery.
背景
吸烟者和烟草公司都清楚吸烟会增加患癌症、血管疾病和过早死亡的风险。本文综述了长期吸烟对脊柱组织和脊柱手术产生的大量不良影响。
方法
通过在医学文献数据库（PubMed）和谷歌学术数据库中搜索与吸烟、脊柱病和脊柱手术相关的关键词，查找相关文献。
结果
吸烟通过动脉粥样硬化和血栓形成损害脊柱组织的血管供应，同时导致局部缺氧、炎症、蛋白水解和细胞丢失，从而加速脊柱病的发展。因此，它会损害椎间盘、软骨、滑膜、骨骼和血管。吸烟可导致早期手术、伤口愈合延迟、手术部位感染增加、融合失败、再次手术增多以及慢性脊柱疼痛。
结论
有充分证据支持外科医生拒绝为长期吸烟者进行手术。对于考虑进行脊柱手术或已经接受脊柱手术的患者，应强调立即戒烟并永久戒烟的必要性及其潜在益处。
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