An article published in Spine examined how smoking impacted posterolateral fusions.
The research includes 281 patients who underwent single- or two-level PLF during a 21-year period. There were 231 patients who were non-smokers and 50 who were smokers. The patients were followed for an average of 53.5 months. The researchers found:
1. The complication rate among nonsmokers was 3.5 percent, compared with the fusion rate among smokers, which was 7.69 percent. The difference was not significantly different.
2. Pseudarthrosis occurred in nonsmokers for 9.82 percent of the cases, which is higher than 7.69 percent in the smokers group.
3. Two-level posterolateral fusion complications among nonsmokers was 6.72 percent. For smokers, the complication rate for two-level procedures was 4.17 percent.
4. Pseudarthrosis rates were significantly higher in the smoker group than the nonsmoker group for two-level procedures. Pseudarthritis was 29.17 percent for smokers, compared with 10.92 percent for nonsmokers.
"Smoking did not lead to significantly higher overall complication rates for patients undergoing one- or two-level PLF in this study," concluded the authors. "Patients should be cautioned against the detrimental effects of smoking in fusion rates after multilevel PLF of the lumbar spine."