In an earlier post we talked about the harmful effects of tobacco and its relationship with back injuries. I will not talk about the same thing. Today’s focus is on the decision to undergo surgery. In this web we have talked about the criteria that advice or not a surgery but we have limited ourselves to the clinical questions. There are always “minor” factors that can change the balance to a different decision. One of these factors in tobacco.
What happens when a smoker operates the back?
In general we can say that the results of this surgery will be clearly worse for many reasons. Everything I comment on here is proven by serious studies. Let’s go see it:
– There are more complications. There are major problems in achieving closure and subsequent healing of the surgical wound. More infections also occur with the associated problems that this entails.
– Increased rate of failure to achieve fusion after an arthrodesis. As I said in the post about arthrodesis, in this surgery the bone is supposed to consolidate and fix the joint. In this way a block of bone is produced that eliminates the mobility in the operated segment. While this happens, they are put some bars and screws to hold it. Smokers often fail this consolidation and complications occur when the implanted material ends up tiring and not holding up.
– Smokers need to use more analgesics during recovery from surgery.
– The functional outcome is worse in the gait pattern after surgery.
– One study showed how smokers had a worse quality of life two years after surgery compared to nonsmokers.
Is smoking a reason not to operate?
Today the reality is that it is not taken into account but it should be. The studies that have emerged in the last years may have to rethink their importance. In every surgery there must be a balance between the risk we assume and the benefit we can get. For all the aforementioned, tobacco may even lower this balance in some cases.
What if I stop smoking before I have surgery?
If a person leaves the smoking habit definitely and then undergo surgery, things change. The outcome of surgery in patients who quit smoking is close to that of non-smokers. It is not the same but is closer to normal than the results of people who continue with tobacco.
In short if you are going to operate from the back you must stop smoking. If you are not going to do it, you may need to reevaluate the balance between the risk and the benefit of having surgery.
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