Does smoking have an impact on fusion rate in single-level anterior cervical discectomy and fusion with allograft and rigid plate fixation? Clinical article.

Luszczyk, Myles; Smith, Justin S; Fischgrund, Jeffrey S; Ludwig, Steven C; Sasso, Rick C; Shaffrey, Christopher I; Vaccaro, Alexander R

Does smoking have an impact on fusion rate in single-level anterior cervical discectomy and fusion with allograft and rigid plate fixation? Clinical article.

dc.contributor.author	Luszczyk, Myles
dc.contributor.author	Smith, Justin S
dc.contributor.author	Fischgrund, Jeffrey S
dc.contributor.author	Ludwig, Steven C
dc.contributor.author	Sasso, Rick C
dc.contributor.author	Shaffrey, Christopher I
dc.contributor.author	Vaccaro, Alexander R
dc.date.accessioned	2023-08-29T23:29:35Z
dc.date.available	2023-08-29T23:29:35Z
dc.date.issued	2013-11
dc.date.updated	2023-08-29T23:29:35Z
dc.description.abstract	Object Although smoking has been shown to negatively affect fusion rates in patients undergoing multilevel fusions of the cervical and lumbar spine, the effect of smoking on fusion rates in patients undergoing single-level anterior cervical discectomy and fusion (ACDF) with allograft and plate fixation has yet to be thoroughly investigated. The objective of the present study was to address the effect of smoking on fusion rates in patients undergoing a 1-level ACDF with allograft and a locked anterior cervical plate. Methods This study is composed of patients from the control groups of 5 separate studies evaluating the use of an anterior cervical disc replacement to treat cervical radiculopathy. For each of the 5 studies the control group consisted of patients who underwent a 1-level ACDF with allograft and a locked cervical plate. The authors of the present study reviewed data obtained in a total of 573 patients; 156 patients were smokers and 417 were nonsmokers. A minimum follow-up period of 24 months was required for inclusion in this study. Fusion status was assessed by independent observers using lateral, neutral, and flexion/extension radiographs. Results An overall fusion rate of 91.4% was achieved in all 573 patients. A solid fusion was shown in 382 patients (91.6%) who were nonsmokers. Among patients who were smokers, 142 (91.0%) had radiographic evidence of a solid fusion. A 2-tailed Fisher exact test revealed a p value of 0.867, indicating no difference in the union rates between smokers and nonsmokers. Conclusions The authors found no statistically significant difference in fusion status between smokers and nonsmokers who underwent a single-level ACDF with allograft and a locked anterior cervical plate. Although the authors do not promote tobacco use, it appears that the use of allograft with a locked cervical plate in single-level ACDF among smokers produces similar fusion rates as it does in their nonsmoking counterparts.
dc.identifier.issn	1547-5654
dc.identifier.issn	1547-5646
dc.identifier.uri	https://hdl.handle.net/10161/28813
dc.language	eng
dc.publisher	Journal of Neurosurgery Publishing Group (JNSPG)
dc.relation.ispartof	Journal of neurosurgery. Spine
dc.relation.isversionof	10.3171/2013.7.spine13208
dc.subject	Cervical Vertebrae
dc.subject	Humans
dc.subject	Radiculopathy
dc.subject	Radiography
dc.subject	Treatment Outcome
dc.subject	Spinal Fusion
dc.subject	Diskectomy
dc.subject	Retrospective Studies
dc.subject	Follow-Up Studies
dc.subject	Bone Plates
dc.subject	Smoking
dc.subject	Adult
dc.subject	Intervertebral Disc
dc.subject	Allografts
dc.title	Does smoking have an impact on fusion rate in single-level anterior cervical discectomy and fusion with allograft and rigid plate fixation? Clinical article.
dc.type	Journal article
duke.contributor.orcid	Shaffrey, Christopher I\|0000-0001-9760-8386
pubs.begin-page	527
pubs.end-page	531
pubs.issue	5
pubs.organisational-group	Duke
pubs.organisational-group	School of Medicine
pubs.organisational-group	Clinical Science Departments
pubs.organisational-group	Orthopaedic Surgery
pubs.organisational-group	Neurosurgery
pubs.publication-status	Published
pubs.volume	19