Tobacco Works against Successful Neck Fusion

Serious neck problems are sometimes treated with surgery to fuse together one or more bones. Fusion may be the best treatment for some patients with disc protrusion. It's also used for patients with a narrow opening for the spinal cord. These conditions can put pressure on the spinal cord or the nerves as they leave the spinal cord.

Doctors know that worker's compensation (WC) patients with low back problems typically don't do as well as those who aren't receiving WC, for various reasons. A group of doctors at St. Luke's Medical Center in Chicago wanted to know if this difference was also true for neck pain patients.

Would someone on WC have a worse result after neck fusion? The authors compared two groups of patients. There were 30 patients in the WC group and 50 patients in the non-WC group. Both groups had similar neck problems and were treated with the same fusion operation.

There was no difference in the results for these two groups. Patients returned to work about the same time. The strength of the fusion was equal between the two groups. Pain relief and use of pain medication was also the same.

There was one difference in these two groups. The patients who used tobacco had poorer results. They were more likely to have a weak fusion or places where false joints (called pseudoarthroses) formed.



References: Edward J. Goldberg, MD, et al. Comparing Outcomes of Anterior Cervical Discectomy and Fusion in Workman's Versus Non-workman's Compensation Population. In The Spine Journal.November/December 2002. Vol. 2. No. 6. Pp.408-414.