Lim Seokchun, Schultz Lonni, Zakko Philip, Macki Mohamed, Hamilton Travis, Pawloski Jacob, Fadel Hassan, Mansour Tarek, Yeh Hsueh-Han, Preston Gordon, Nerenz David, Schwalb Jason M, Abdulhak Muwaffak, Park Paul, Aleem Ilyas, Easton Richard, Khalil Jad, Perez-Cruet Miguelangelo, Park Daniel, Chang Victor
Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA; Department of Public Health Sciences, Henry Ford Hospital, Detroit, Michigan, USA.
World Neurosurg. 2023 May;173:e241-e249. doi: 10.1016/j.wneu.2023.02.038. Epub 2023 Feb 14.
To review the Michigan Spine Surgery Improvement Collaborative registry to investigate the long-term associations between current smoking status and outcomes after elective cervical and lumbar spine surgery.
Using the Michigan Spine Surgery Improvement Collaborative, we captured all cases from January 1, 2017, to November 21, 2020, with outcomes data available; 19,251 lumbar cases and 7936 cervical cases were included. Multivariate regression analyses were performed to assess the relationship of smoking with the clinical outcomes.
Current smoking status was associated with lower urinary retention and satisfaction for patients after lumbar surgery and was associated with less likelihood of achieving minimal clinically important difference in primary outcome measures including Patient-Reported Outcomes Measurement Information System, back pain, leg pain, and EuroQol-5D at 90 days and 1 year after surgery. Current smokers were also less likely to return to work at 90 days and 1 year after surgery. Among patients who underwent cervical surgery, current smokers were less likely to have urinary retention and dysphagia postoperatively. They were less likely to be satisfied with the surgery outcome at 1 year. Current smoking was associated with lower likelihood of achieving minimal clinically important difference in Patient-Reported Outcomes Measurement Information System, neck pain, arm pain, and EuroQol-5D at various time points. There was no difference in return-to-work status.
Our analysis suggests that smoking is negatively associated with functional improvement, patient satisfaction, and return-to-work after elective spine surgery.
回顾密歇根脊柱手术改善协作登记处的数据，以研究当前吸烟状况与择期颈椎和腰椎手术后结局之间的长期关联。
利用密歇根脊柱手术改善协作项目，我们收集了2017年1月1日至2020年11月21日期间所有有结局数据的病例；纳入了19251例腰椎病例和7936例颈椎病例。进行多变量回归分析以评估吸烟与临床结局之间的关系。
当前吸烟状况与腰椎手术后患者的尿潴留及满意度较低相关，并且与术后90天和1年时在包括患者报告结局测量信息系统、背痛、腿痛和欧洲五维健康量表等主要结局指标上达到最小临床重要差异的可能性较小相关。当前吸烟者在术后90天和1年时重返工作岗位的可能性也较小。在接受颈椎手术的患者中，当前吸烟者术后发生尿潴留和吞咽困难的可能性较小。他们在术后1年时对手术结局的满意度较低。当前吸烟与在不同时间点在患者报告结局测量信息系统、颈部疼痛、手臂疼痛和欧洲五维健康量表上达到最小临床重要差异的可能性较低相关。重返工作状态没有差异。
我们的分析表明，吸烟与择期脊柱手术后的功能改善、患者满意度和重返工作呈负相关。
