title: Influence of smoking on spinal fusion after spondylodesis surgery: A comparative clinical study.
abstract: BACKGROUND
  Smoking is a risk factor in the process of bone healing after lumbar spondylodesis, often associated with complications that occur intraoperatively or during follow-up periods.
  
  
  OBJECTIVE
  To assess if smokers yield worse results concerning lumbar interbody fusion than non-smokers in a clinical comparative setting.
  
  
  METHODS
  Spondylodesis outcomes in 50 patients, 34 non-smokers (mean 58 years; (range 29-81) and 16 smokers (mean 47 years; range 29-75) were compared preoperatively and one year after spondylodesis surgery using Oswestry-Disability-Index (ODI), visual analogue scale (VAS) and radiological outcome analysis of fusion-success.
  
  
  RESULTS
  Smokers showed a comparable ODI-improvement (p = 0.9343) and pain reduction to non-smokers (p = 0.5451). The intake of opioids was only reduced in non-smokers one year after surgery. Fusion success was significantly better in non-smokers (p = 0.01).
  
  
  CONCLUSIONS
  The results indicate that smoking adversely effects spinal fusion. Particularly re-operations caused by pseudarthrosis occur at a higher rate in smokers than in non-smokers.
authors.forename: Pia C
authors.initials: PC
authors.lastname: Hermann
authors.forename: Markus
authors.initials: M
authors.lastname: Webler
authors.forename: Rahel
authors.initials: R
authors.lastname: Bornemann
authors.forename: Tom R
authors.initials: TR
authors.lastname: Jansen
authors.forename: Yorck
authors.initials: Y
authors.lastname: Rommelspacher
authors.forename: Kirsten
authors.initials: K
authors.lastname: Sander
authors.forename: Philip P
authors.initials: PP
authors.lastname: Roessler
authors.forename: Sönke P
authors.initials: SP
authors.lastname: Frey
authors.forename: Robert
authors.initials: R
authors.lastname: Pflugmacher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Smoking; outcome; risk factor; spondylodesis