• Seokchun Lim, Lonni Schultz, Philip Zakko, Mohamed Macki, Travis Hamilton, Jacob Pawloski, Hassan Fadel, Tarek Mansour, Hsueh-Han Yeh, Gordon Preston, David Nerenz, Jason M Schwalb, Muwaffak Abdulhak, Paul Park, Ilyas Aleem, Richard Easton, Jad Khalil, Miguelangelo Perez-Cruet, Daniel Park, and Victor Chang.
• Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
• World Neurosurg. 2023 May 1; 173: e241e249e241-e249.

ObjectiveTo review the Michigan Spine Surgery Improvement Collaborative registry to investigate the long-term associations between current smoking status and outcomes after elective cervical and lumbar spine surgery.MethodsUsing the Michigan Spine Surgery Improvement Collaborative, we captured all cases from January 1, 2017, to November 21, 2020, with outcomes data available; 19,251 lumbar cases and 7936 cervical cases were included. Multivariate regression analyses were performed to assess the relationship of smoking with the clinical outcomes.ResultsCurrent smoking status was associated with lower urinary retention and satisfaction for patients after lumbar surgery and was associated with less likelihood of achieving minimal clinically important difference in primary outcome measures including Patient-Reported Outcomes Measurement Information System, back pain, leg pain, and EuroQol-5D at 90 days and 1 year after surgery. Current smokers were also less likely to return to work at 90 days and 1 year after surgery. Among patients who underwent cervical surgery, current smokers were less likely to have urinary retention and dysphagia postoperatively. They were less likely to be satisfied with the surgery outcome at 1 year. Current smoking was associated with lower likelihood of achieving minimal clinically important difference in Patient-Reported Outcomes Measurement Information System, neck pain, arm pain, and EuroQol-5D at various time points. There was no difference in return-to-work status.ConclusionsOur analysis suggests that smoking is negatively associated with functional improvement, patient satisfaction, and return-to-work after elective spine surgery.Copyright © 2023 Elsevier Inc. All rights reserved.

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