Castillo Jose, Zhou James, Urreola Gabriel, Le Michael Nhien, Ortuno Omar, Kercher Matthew, Kim Kee, Price Richard L, Martin Allan R
Department of Neurosurgery, University of California, Sacramento, CA 95817, USA.
J Clin Med. 2025 Jul 28;14(15):5332. doi: 10.3390/jcm14155332.
Smoking is known to impair fracture healing and worsen surgical outcomes, but its effect on psychological recovery in spine trauma patients remains unclear. The purpose of this study is to assess how smoking affects pain and anxiety in patients with spine fractures treated either conservatively or surgically. We conducted a retrospective analysis looking at spine fracture patients > 18 years old seen at a single institution between 11/2015 and 9/2019. Patient variables such as age, sex, race, ethnicity, mechanism of injury, fracture location, presence of spinal cord injury, surgical intervention, hospital and ICU LOS, disposition, and EQ-5D-3L at 3 and 12 months were collected and analyzed. Non-operative management was selected for 403 patients, of which 304 never smoked and 99 were smokers. Surgical management was utilized for 126 patients, of which 90 never smoked and 36 were smokers. Studying non-smokers and current smokers, higher levels of extreme pain and anxiety at 3 and 12 months were reported in smokers managed conservatively. Smokers managed surgically reported higher levels of pain and anxiety than non-smokers at 3 months but not at 12 months. No significant differences were seen with regards to changes in pain or anxiety between the 3- and 12-month follow-up. Smoking is independently associated with higher levels of pain and anxiety in conservatively managed spine fracture patients. These findings suggest a need for early intervention and cessation efforts in the trauma setting. Further investigation is warranted to clarify whether underlying psychological or physiological phenomena are impacting patient outcomes.
众所周知，吸烟会损害骨折愈合并使手术效果恶化，但其对脊柱创伤患者心理恢复的影响仍不明确。本研究的目的是评估吸烟如何影响接受保守治疗或手术治疗的脊柱骨折患者的疼痛和焦虑情况。我们进行了一项回顾性分析，研究对象为2015年11月至2019年9月期间在单一机构就诊的18岁以上脊柱骨折患者。收集并分析了患者的变量，如年龄、性别、种族、民族、损伤机制、骨折部位、脊髓损伤情况、手术干预、住院和重症监护病房住院时间、出院情况以及3个月和12个月时的EQ-5D-3L评分。403例患者选择了非手术治疗管理，其中304例从不吸烟，99例吸烟。126例患者采用了手术治疗管理，其中90例从不吸烟，36例吸烟。在研究不吸烟者和当前吸烟者时，保守治疗的吸烟者在3个月和12个月时报告的极度疼痛和焦虑水平更高。接受手术治疗的吸烟者在3个月时报告的疼痛和焦虑水平高于不吸烟者，但在12个月时并非如此。在3个月和12个月的随访中，疼痛或焦虑变化方面未发现显著差异。在保守治疗的脊柱骨折患者中，吸烟与更高水平的疼痛和焦虑独立相关。这些发现表明在创伤环境中需要早期干预和戒烟努力。有必要进一步调查以澄清潜在的心理或生理现象是否正在影响患者的治疗结果。
