Research

Does smoking affect the outcomes of lumbar decompression surgery?

¹ Plymouth University Penisula School of Medicine and Dentistry, Tamar Science Park, Research Way, Plymouth, Devon PL6 8DH, UK
² Southwest Neurosurgery Centre, Derriford Hospital, Plymouth PL6 8DH, UK

^* Corresponding author: radha.mehta@hotmail.co.uk

Received: 29 November 2016
Accepted: 7 September 2017

Abstract

Introduction: Lumbar decompressions and micro-discectomies are commonly performed non-complex spinal surgeries that do not involve the insertion of metalwork into the spine and are done for symptomatic disc prolapse and lumbar spinal stenosis, whereas complex-spinal surgery does require metalwork [1]. Studies of complex-spinal surgeries show that smoking has a significant negative impact on the outcome of the surgery [2] therefore, the cessation of smoking is advised prior to surgery [3]. There are evidences in the literature supportive as well as opposing this statement about continued smoking and poor outcome of decompressive spinal surgeries.

Methods: We retrospectively reviewed 143 consecutive patients who have had either a micro-discectomy or a micro-decompression.

Results: We found no statistical difference between smokers and non-smokers in the outcomes of lumbar decompression surgery. Both groups improved equally and significantly in terms of back pain, leg pain and functions. Out of 143 patients, only 2% more non-smokers had improved leg pain compared to smokers, 1% less non-smokers had improved back pain and 2% more non-smokers had an improved Oswestry Disability Index (ODI) score.

Discussion: We recommend that it is important to surgically treat both smokers and non-smokers in need of a lumbar spinal decompression.