Smoking Does Not Negatively Impact Outcomes Following Cervical Laminoplasty: A Quality Outcomes Database Study.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2024-11-21 DOI:10.1097/BSD.0000000000001732

Brian Q Hou, Andrew Croft, Hani Chanbour, Omar Zakieh, Hui Nian, Jacquelyn S Pennings, Mitchell Bowers, Mason W Young, William H Waddell, Amir M Abtahi, Raymond J Gardocki, Julian G Lugo-Pico, Scott L Zuckerman, Byron F Stephens

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Abstract

Study design: Retrospective cohort study.

Objective: To assess the impact of smoking on outcomes following elective cervical laminoplasty for degenerative cervical myelopathy (DCM).

Summary of background data: The detrimental effect of cigarette smoking on cervical spinal fusion surgery outcomes is well documented. However, the impact of smoking on outcomes following nonfusion cervical spine procedures is unknown. One commonly utilized nonfusion technique for cervical decompression is laminoplasty.

Methods: Adult smokers or nonsmokers who underwent primary elective laminoplasty for DCM were included. The propensity score (PS) was constructed for being a current smoker based on covariates. Only patients contained in the PS overlapped region were included in the analysis set. Patient-reported outcomes (PROs) at baseline and 12 months postoperation included Visual Analog Scale (VAS) neck and arm pain, neck disability index (NDI)%, EuroQol-5 Dimension (EQ-5D), and modified Japanese Orthopedic Association (mJOA) scores. Other outcomes included perioperative complications, 3-month readmissions/reoperations, and patient satisfaction. Wilcoxon and Pearson tests were used to compare outcomes between smokers and nonsmokers.

Results: The study included 132 patients: 30 were smokers (22.7%) and 102 were nonsmokers (77.3%). No significant differences were found at baseline between groups in demographics or medical history. Smokers had significantly worse baseline VAS neck pain (5.7±3.2 vs. 4.4±3.04, P=0.028) and arm pain (5.7±3.5 vs. 4.3±3.2, P=0.045) scores, but all other baseline PROs were not statistically different between groups. No differences were found between smokers and nonsmokers in any 12-month PRO, or in rates of perioperative complications, 3-month readmissions, or 3-month reoperations. On multivariable logistic regression analysis, smoking had no significant impact on any outcome of interest.

Conclusion: Clinical and PROs following elective laminoplasty for DCM are not significantly different between smokers and nonsmokers. Laminoplasty should be considered a good surgical option in smokers presenting with DCM.

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吸烟不会对颈椎板层成形术后的疗效产生负面影响：质量结果数据库研究

研究设计回顾性队列研究：评估吸烟对退行性颈椎脊髓病（DCM）选择性颈椎板成形术后疗效的影响：吸烟对颈椎融合手术疗效的不利影响已得到充分证实。然而，吸烟对非融合颈椎手术疗效的影响尚不清楚。一种常用的颈椎减压非融合技术是椎板成形术：方法：纳入因 DCM 而接受初级选择性椎板成形术的成年吸烟者或非吸烟者。根据协变量构建了当前吸烟者的倾向评分（PS）。分析集中仅包括 PS 重叠区域内的患者。基线和术后12个月的患者报告结果（PROs）包括视觉模拟量表（VAS）颈部和手臂疼痛、颈部残疾指数（NDI）%、欧洲量表（EQ-5D）和日本骨科协会（mJOA）评分。其他结果包括围手术期并发症、3 个月再入院/再手术以及患者满意度。采用Wilcoxon和Pearson检验比较吸烟者和非吸烟者的结果：研究包括 132 名患者：其中30人为吸烟者（22.7%），102人为不吸烟者（77.3%）。两组患者的基线人口统计学和病史无明显差异。吸烟者的基线 VAS 颈部疼痛（5.7±3.2 vs. 4.4±3.04，P=0.028）和手臂疼痛（5.7±3.5 vs. 4.3±3.2，P=0.045）评分明显较差，但各组间的所有其他基线 PROs 均无统计学差异。吸烟者和非吸烟者在 12 个月的 PRO、围术期并发症发生率、3 个月再入院率或 3 个月再手术率方面均无差异。在多变量逻辑回归分析中，吸烟对任何相关结果都没有显著影响：结论：吸烟者和非吸烟者在选择性板层成形术治疗DCM后的临床和PROs无明显差异。对于患有 DCM 的吸烟者来说，板层成形术应被视为一种很好的手术选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.