Kennedy Yalamanchili, M.D. F.A.C.S.

I am planning on undergoing a spinal surgery, why do I need to quit smoking?

Smoking causes a substantial amount of problems for patients a undergoing spinal fusion including: Decreased rate of successful fusion, poorer clinical outcomes, such as decreased pain, lower patient satisfaction with spine surgery

What other effects does smoking have on me related to surgery? 

Amongst the biggest risks of cancer and pulmonary disease, smoking has also been shown to decrease circulation, increase mucous production, increase infections, irritate digestive tract, and block absorption of nutrients. Smoking has adverse effects on the blood flow to tissues that may impair wound healing. Smoking compromises the immune system and the body's defense mechanisms, which increases the risk post-operative infection. In one study, more than 50% of patients who continued smoking after surgery developed complications, compared with less than 20% of those who quit.

 

How does smoking effect anesthesia?

Smokers have an increase production of mucous which can block airways. Smoking also increases airway sensitivity which makes the airway prone to narrowing during anesthesia. Narrowed airways will slow oxygen delivery and can be life threatening. Smoking also decreases the ability to carry oxygen in the blood. Studies have also demonstrated an increased risk of respiratory complications during and after general anesthesia in smokers.

 

How does smoking prevent me from fusing?

During your spinal fusion, a bone graft is placed. This bone graft grows and creates new bone to fuse with your own bone but requires nutrients from blood supply to do so. Nicotine constricts blood vessels, decreasing blood supply and blocks nutrients. Because of the lack of blood supply and decreased amount of nutrients, the bone graft cannot form a fusion. Nicotine also has been shown to kill the cells in your body that are responsible for bone growth.

 

Just how much does smoking effect fusion rates?

Research and studies on smoking and its effect on fusion has shown the fusion rates for non-smokers is less than 10% whereas in smokers it is higher than 30%. Some studies have even demonstrated a 50% rate of unsuccessful fusion. In a study of patients undergoing anterior cervical fusion, it was found that smokers had an increased rate of nonunion of up to 47% compared to non-smokers. Another study of patients undergoing lumbar fusion had failed fusions in up to 40% of cases, compared to only 8% among non-smokers.

 

Why do I have to quit prior to surgery?

Studies show if you smoke up until the time of surgery you are highly unlikely to quit after surgery and the longer you abstain from smoking prior to surgery, the more likely you will continue to abstain.

 

 

What does smoking have to do with my pain?

There is a strong correlation between smoking and chronic pain. Smokers have been shown to have about a 300% higher incidence of chronic low back pain. This means just stopping smoking may help to alleviate your pain. Smoking has been found to accelerate the rate of disc degeneration and this might contribute to ongoing spine problems even after a spine fusion.