Murray Echt1, Rafael De la Garza Ramos1, Jonathan Nakhla1, Yaroslav Gelfand1, Phillip Cezayirli1, Ryan Holland1, Merritt D Kinon1, Reza Yassari2. 1. Spine Research Group, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA; Department of Neurological Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA. 2. Spine Research Group, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA; Department of Neurological Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA. Electronic address: ryassari@montefiore.org.
Abstract
OBJECTIVE: To evaluate the impact of cigarette smoking on the development of wound complications, including wound dehiscence, superficial infection, deep infection, or organ space infection, within the first 30 postoperative days in patients undergoing surgery for spondylolisthesis. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for the years 2012-2014 was used to identify adult patients who underwent single-level posterolateral fusion (PLF) or interbody fusion for spondylolisthesis. Wound complications occurring within 30 days were compared between current smokers and nonsmokers. RESULTS: A total of 1688 patients who underwent single-level PLF or interbody fusion for spondylolisthesis were identified, among whom 271 were current smokers (16.1%). The overall wound complication rate was 3.3% for smokers versus 1.8% for nonsmokers (P = 0.095). When stratified by operative technique, the rate of wound complications was not significantly different between smokers and nonsmokers undergoing PLF (2.4% vs. 2.6%; P = 1.00); however, smokers who underwent interbody fusion were more likely to experience a wound complication compared with nonsmokers undergoing interbody fusion (3.7% vs. 1.3%; P = 0.028). On multivariate analysis, smoking was an independent predictor of organ/space infection irrespective of fusion technique used (odds ratio, 15.4; 95% confidence interval, 1.34-175.4; P = 0.028). CONCLUSIONS: The rate of wound complications was not higher in smokers undergoing PLF alone, but was significantly higher in smokers who underwent interbody fusion. However, multivariate analysis identified smoking as an independent predictor of organ/space infection irrespective of fusion technique used.
OBJECTIVE: To evaluate the impact of cigarette smoking on the development of wound complications, including wound dehiscence, superficial infection, deep infection, or organ space infection, within the first 30 postoperative days in patients undergoing surgery for spondylolisthesis. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for the years 2012-2014 was used to identify adult patients who underwent single-level posterolateral fusion (PLF) or interbody fusion for spondylolisthesis. Wound complications occurring within 30 days were compared between current smokers and nonsmokers. RESULTS: A total of 1688 patients who underwent single-level PLF or interbody fusion for spondylolisthesis were identified, among whom 271 were current smokers (16.1%). The overall wound complication rate was 3.3% for smokers versus 1.8% for nonsmokers (P = 0.095). When stratified by operative technique, the rate of wound complications was not significantly different between smokers and nonsmokers undergoing PLF (2.4% vs. 2.6%; P = 1.00); however, smokers who underwent interbody fusion were more likely to experience a wound complication compared with nonsmokers undergoing interbody fusion (3.7% vs. 1.3%; P = 0.028). On multivariate analysis, smoking was an independent predictor of organ/space infection irrespective of fusion technique used (odds ratio, 15.4; 95% confidence interval, 1.34-175.4; P = 0.028). CONCLUSIONS: The rate of wound complications was not higher in smokers undergoing PLF alone, but was significantly higher in smokers who underwent interbody fusion. However, multivariate analysis identified smoking as an independent predictor of organ/space infection irrespective of fusion technique used.
Authors: Zachary T Sharfman; Yaroslav Gelfand; Henry Hoang; Rafael De La Garza Ramos; Jaime A Gomez; Jonathan Krystal; David Kramer; Reza Yassari Journal: J Craniovertebr Junction Spine Date: 2022-06-13
Authors: Michelle Connor; Robert G Briggs; Phillip A Bonney; Krista Lamorie-Foote; Kristina Shkirkova; Elliot Min; Li Ding; William J Mack; Frank J Attenello; John C Liu Journal: Global Spine J Date: 2020-10-08