Influence of smoking status and cumulative smoking exposure on neurological recovery after surgery for degenerative cervical myelopathy: a prospective multicenter study.
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引用次数: 0
Abstract
Study design: Prospective multicenter cohort study.
Objectives: To evaluate the association of smoking status and cumulative smoking exposure with postoperative neurological outcomes in patients undergoing surgery for degenerative cervical myelopathy (DCM).
Setting: Multiple institutions in Japan.
Methods: A total of 935 patients with DCM were categorized as non-, past-, or current-smokers. Demographic characteristics, operative variables, and postoperative outcomes, including the Japanese Orthopaedic Association (JOA) score and recovery rate, JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), Short Form-36, visual analog scale, and Neuropathic Pain Symptom Inventory, were evaluated over a 2-year follow-up. Postoperative outcomes were analyzed across smoking categories using general linear models. Among current-smokers, cumulative smoking exposure was quantified using the Brinkman index and examined in relation to postoperative outcomes.
Results: Differences in postoperative functional outcomes, including the JOA recovery rate and JOACMEQ upper and lower extremity functions, were observed across smoking categories. In contrast, neurological recovery, health-related quality-of-life measures, pain intensity, and overall neuropathic pain scores were generally comparable between the groups. Among current-smokers, cumulative smoking exposure did not demonstrate a clear association with neurological or functional outcomes; however, exploratory analyses identified differences in improvement in specific neuropathic sensory symptoms.
Conclusion: Smoking status was associated with differences in postoperative functional recovery after DCM surgery. In contrast, cumulative smoking exposure among current-smokers showed exploratory associations with specific neuropathic sensory outcomes but not with overall neurological or functional recovery. These findings suggest that smoking status and cumulative exposure may influence different outcome domains, supporting smoking cessation as part of preoperative patient management.
期刊介绍：
Spinal Cord is a specialised, international journal that has been publishing spinal cord related manuscripts since 1963. It appears monthly, online and in print, and accepts contributions on spinal cord anatomy, physiology, management of injury and disease, and the quality of life and life circumstances of people with a spinal cord injury. Spinal Cord is multi-disciplinary and publishes contributions across the entire spectrum of research ranging from basic science to applied clinical research. It focuses on high quality original research, systematic reviews and narrative reviews.
Spinal Cord''s sister journal Spinal Cord Series and Cases: Clinical Management in Spinal Cord Disorders publishes high quality case reports, small case series, pilot and retrospective studies perspectives, Pulse survey articles, Point-couterpoint articles, correspondences and book reviews. It specialises in material that addresses all aspects of life for persons with spinal cord injuries or disorders. For more information, please see the aims and scope of Spinal Cord Series and Cases.
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