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Cigarette Smoking’s Impact on Postoperative Healing

Smoking cigarette hovering over an ashtray on a black background

It is not new knowledge that smoking can be detrimental to your health. There are several reasons not to smoke and a large number of these reasons revolve around the possible health issues that can arise from smoking. Although minimally invasive spine surgery may not seem like something that would be necessarily affected by smoking, studies have actually found that smoking can negatively impact postoperative healing.

A large number of Neuro and Orthopedic surgeons agree that smoking is extremely detrimental to post-operative healing after any type of spine surgery, minimally invasive or otherwise. Some even feel so strongly about this that they refuse to perform surgery until the patient decreases their smoking, while others require their patients to quit tobacco entirely before surgery.

It is recommended to stop smoking approximately eight weeks before surgery and maintain this for up to six weeks after surgery. This allows the risks from smoking to be minimized, and gives the body a chance to heal itself. Once the healing process is over, smoking is not as detrimental to spinal health. However it still remains detrimental to one’s overall health.

The reasoning behind this is to prevent any postoperative complications. With smokers, it’s not a question of whether they will have complications, it’s a matter of what complications they will develop. Although there is a small number of smokers that slide by without complications, most smokers are negatively affected in some way.

The two most common complications affecting smokers is a lower rate of spinal fusion and an increased rate of infection. This is because smoking slows circulation, meaning that less oxygen and nutrients are delivered to the cells. Spinal discs already receive little circulation and then this is further reduced by smoking, which makes it harder for the discs to heal after surgery. In some cases, the fusion is unable to heal because of this. In addition, the reduced rate of circulation also means that wounds take longer to heal and the risk of infection is much higher.

These negative effects are not limited to just traditional cigarettes, and e-cigarettes can cause the same complications. Despite having lower concentrations of carcinogenic materials, e-cigarettes still have nicotine levels comparable to those in traditional cigarettes. Nicotine negatively affects fusion healing because it has a detrimental effect on the cells of the spinal discs. Therefore, any intake of nicotine can be dangerous, whether it’s traditional or e-cigarettes.

In addition to the possible complications associated with spinal healing, smokers can also have respiratory or cardiac complications that can affect their ability to heal. Since smoking causes your lungs and heart to not work as effectively, there can be issues when they are put under the stress caused by surgery. Smokers have a higher chance of developing breathing problems or pneumonia, and may even need a ventilator after surgery. The risk of heart during or after surgery also is increased with smokers.

Overall, smoking can cause a number of issues for patients undergoing spinal surgery of any kind. It is explicitly recommended that quitting is the best option to improve postoperative success and minimize the rate of postoperative complications.

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