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Does daily tobacco smoking affect outcomes after microdecompression for degenerative central lumbar spinal stenosis? – A multicenter observational registry-based study

  • Experimental research - Spine
  • Published:
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Abstract

Background

There are limited scientific data on the impact of smoking on patient-reported outcomes following minimally invasive spine surgery. The aim of this multicenter observational study was to examine the relationship between daily smoking and patient-reported outcome at 1 year using the Oswestry Disability Index (ODI) after microdecompression for single- and two-level central lumbar spinal stenosis (LSS). Secondary outcomes were the length of hospital stays, perioperative and postoperative complications.

Method

Data were collected through the Norwegian Registry for Spine Surgery (NORspine).

Results

A total of 825 patients were included (619 nonsmokers and 206 smokers). For the whole patient population there was a significant difference between preoperative ODI and ODI at 1 year (17.3 points, 95 % CI 15.93–18.67, p < 0.001). There was a significant difference in ODI change at 1 year between nonsmokers and smokers (4.2 points, 95 % CI 0.98–7.34, p = 0.010). At 1 year 69.6 % of nonsmokers had achieved a minimal clinically important difference (≥10 points ODI improvement) compared to 60.8 % of smokers (p = 0.008). There was no difference between nonsmokers and smokers in the overall complication rate (11.6 % vs. 9.2 %, p = 0.34). There was no difference between nonsmokers and smokers in length of hospital stays for either single-level (2.3 vs. 2.2 days, p = 0.99) or two-level (3.1 vs. 2.3 days, p = 0.175) microdecompression. Smoking was identified as a negative predictor for ODI change in a multiple regression analysis (p = 0.001)

Conclusions

Nonsmokers experienced a significantly larger improvement at 1 year following microdecompression for LSS compared to smokers. Smokers were less likely to achieve a minimal clinically important difference. However, it should be emphasized that considerable improvement also was found among smokers.

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Acknowledgments

The authors would like to thank the Norwegian Registry for Spine Surgery (NORspine). The NORspine registry receives funding from the University of Northern Norway and Norwegian health authorities. We thank all patients and surgeons participating in the NORspine registration.

Funding statement

This study received a grant (Grant for Quality Improvement and Patient Safety) from the Norwegian Medical Association (www.legeforeningen.no). The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.

Conflicts of interests

None.

Authors’ contributions

All authors read and approved the final manuscript. SG: Original concept of the study, study design, collection of data, statistics and writing. TN: Study design, statistics and writing. USN: Writing and collection of data. OS: Statistics and writing. MG: Statistics and writing. CW: Writing and collection of data. CG: Statistics and writing. ØPN: Collection of data and writing. TKS: Collection of data and writing. ASJ: Statistics and writing.

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Authors and Affiliations

  1. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway

    Sasha Gulati, Ulf S. Nerland, Clemens Weber, Charalampis Giannadakis, Øystein P. Nygaard, Ole Solheim & Asgeir S. Jakola

  2. Norwegian Centre of Competence in Deep Brain Stimulation for Movement Disorders, Trondheim, Norway

    Sasha Gulati

  3. Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Sasha Gulati, Ulf S. Nerland, Charalampis Giannadakis, Øystein P. Nygaard & Ole Solheim

  4. Department of Anesthesia, St. Olavs University Hospital, Trondheim, Norway

    Trond Nordseth

  5. Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway

    Trond Nordseth

  6. The Norwegian Air Ambulance Foundation, Drøbak, Norway

    Trond Nordseth

  7. Department of Surgery, Ålesund Hospital, Ålesund, Norway

    Michel Gulati

  8. National Advisory Unit on Spinal Surgery, St. Olavs University Hospital, Trondheim, Norway

    Clemens Weber & Øystein P. Nygaard

  9. Department of Neurosurgery, University Hospital of Northern Norway, Tromsø, Norway

    Tore K. Solberg

  10. The Norwegian National Registry for Spine Surgery, Center for Clinical Documentation and Evaluation (SKDE), North Norway Regional Health Authority, Tromsø, Norway

    Tore K. Solberg

  11. National Centre of Competence in Ultrasound and Image-Guided Surgery, Trondheim, Norway

    Ole Solheim

  12. Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden

    Asgeir S. Jakola

Authors
  1. Sasha Gulati
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  2. Trond Nordseth
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  3. Ulf S. Nerland
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  7. Øystein P. Nygaard
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Corresponding author

Correspondence to Sasha Gulati.

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Gulati, S., Nordseth, T., Nerland, U.S. et al. Does daily tobacco smoking affect outcomes after microdecompression for degenerative central lumbar spinal stenosis? – A multicenter observational registry-based study. Acta Neurochir 157, 1157–1164 (2015). https://doi.org/10.1007/s00701-015-2437-1

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  • DOI: https://doi.org/10.1007/s00701-015-2437-1

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