Smoking status linked with poorer outcomes following cervical myelopathy

According to a presenter at the North American Spine Society Annual Meeting, poor improvement in the Nurick score following surgery for treatment of cervical myelopathy correlated with smoking status.

“These data suggest that patients with cervical myelopathy who smoke are likely to have less improvement in their condition postoperatively, compared to those who do not smoke, and that the effect of each cigarette is additive,” study author David Kusin, MD, said in a press release. “These findings reinforce the importance of counseling patients about smoking cessation prior to surgery.”

Kusin and colleagues performed a retrospective study of 212 consecutive patients diagnosed with cervical spondylotic myelopathy. Patients were categorized into groups regarding their smoking status and were further grouped based on pack years and packs per day. All patients were assessed for a postoperative change in the Nurick score. Simple linear regression and multiple regression were performed for analysis.

Results from univariate analysis indicated nonsmokers had a 1.53-point postoperative improvement on the Nurick scale vs. smokers, who had a 0.6-point improvement. Kusin and colleagues noted as the numbers of pack years and packs per day increased, improvement progressively decreased. Greater improvements in Nurick scores were seen with a greater preoperative score; however, this finding was only seen in patients who smoked fewer than 25 packs per year. Preoperative Nurick score and smoking status were not correlated.

“We found that tobacco use was directly correlated with decreased postoperative improvement in Nurick score,” Kusin said. “Specifically, the mean improvement in Nurick score was almost 1 point lower in smokers than in nonsmokers.”

References:

Kusin D, et al. Paper #6. Presented at: North American Spine Society Annual Meeting; Oct. 26-29, 2016; Boston.

www.spine.org

Disclosure: Kusin reports no relevant financial disclosures.