Just how bad does nicotine impact spinal fusion?
What do I need to know to help my chances of successfully quitting smoking?
Spinal fusion (also termed arthrodesis) is a surgical procedure used to join bony segments of the spine. Fusion techniques are often used in coordination with decompressive surgery in which bone spurs, unhealthy joints, disks and/or calcified ligaments are removed from the spine to decompress the nerves and relieve pain. In order for the fusion to heal, hardware is placed to provide spinal stability and allow new bone growth to occur after surgery. Common hardware used in spine surgery to provide spine support are bone screws, rods and spacers for the disk space. The long term success of surgery is often dependent upon successful bone fusion because bone is actually much stronger and better at handling biomechanical stresses then any hardware that can be used. If fusion does not occur, then the surgery may have to be repeated if the hardware fails. Bone formation and growth is inhibited by smoking and nicotine.
Nicotine can be introduced into the body by several ways:
- Smoking cigarettes
- Smokeless chewing tobacco
- Nicotine patches
- Nicotine gum
- Vaping with electronic cigarettes
Introducing nicotine causes a number of significant problems for patients undergoing spinal fusion. Research has demonstrated that habitual smoking leads to less successful spinal fusions.
Complications include the following:
A significantly decreased rate of successful fusion (called non-union or pseudoarthrosis)
Increase in surgical site infection rates, longer hospital stays, and delayed wound healing.
Poorer clinical outcomes; acceleration of disc degeneration, a slow down or inability to regain normal functionality after surgery, and less overall pain reduction even if there is successful fusion
Of course smoking cessation and quitting all forms of nicotine is also good for the rest of your body especially your lungs, heart and blood vessels. Even if you are not undergoing a spinal fusion surgery, smoking may increase your risks of other complications.
People who are undergoing spinal fusion or any other type of surgery should make every effort to stop smoking. Unfortunately, nicotine is highly addictive and can be extremely difficult to quit. Remember, you are not alone and working with your healthcare provider, asking for support, and utilizing available resources will increase your chances of success!
Here are some resources for smoking cessation: