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

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• 作者：Sasha Gulati ; Trond Nordseth ; Ulf S. Nerland ; Michel Gulati…
• 关键词：Spinal stenosis ; Spondylosis ; Neurosurgical procedures ; Tobacco ; Quality of life
• 刊名：Acta Neurochirurgica
• 出版年：2015
• 出版时间：July 2015
• 年：2015
• 卷：157
• 期：7
• 页码：1157-1164
• 全文大小：333 KB
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• 作者单位：Sasha Gulati (1) (2) (3)
  Trond Nordseth (4) (5) (6)
  Ulf S. Nerland (1) (3)
  Michel Gulati (7)
  Clemens Weber (1) (8)
  Charalampis Giannadakis (1) (3)
  ?ystein P. Nygaard (1) (3) (8)
  Tore K. Solberg (10) (9)
  Ole Solheim (1) (11) (3)
  Asgeir S. Jakola (1) (12)
  
  1. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway
  2. Norwegian Centre of Competence in Deep Brain Stimulation for Movement Disorders, Trondheim, Norway
  3. Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  4. Department of Anesthesia, St. Olavs University Hospital, Trondheim, Norway
  5. Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
  6. The Norwegian Air Ambulance Foundation, Dr?bak, Norway
  7. Department of Surgery, ?lesund Hospital, ?lesund, Norway
  8. National Advisory Unit on Spinal Surgery, St. Olavs University Hospital, Trondheim, Norway
  10. The Norwegian National Registry for Spine Surgery, Center for Clinical Documentation and Evaluation (SKDE), North Norway Regional Health Authority, Troms?, Norway
  9. Department of Neurosurgery, University Hospital of Northern Norway, Troms?, Norway
  11. National Centre of Competence in Ultrasound and Image-Guided Surgery, Trondheim, Norway
  12. Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
  
• 刊物主题：Neurosurgery; Interventional Radiology; Neuroradiology; Neurology; Surgical Orthopedics; Minimally Invasive Surgery;
• 出版者：Springer Vienna
• ISSN：0942-0940

文摘

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 15.93-8.67, p-lt;-.001). There was a significant difference in ODI change at 1 year between nonsmokers and smokers (4.2 points, 95?% CI 0.98-.34, p--.010). At 1 year 69.6?% of nonsmokers had achieved a minimal clinically important difference (?0 points ODI improvement) compared to 60.8?% of smokers (p--.008). There was no difference between nonsmokers and smokers in the overall complication rate (11.6?% vs. 9.2?%, p--.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--.99) or two-level (3.1 vs. 2.3?days, p--.175) microdecompression. Smoking was identified as a negative predictor for ODI change in a multiple regression analysis (p--.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.