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Impact Assessment of Repeated Exposure of Organotypic 3D Bronchial and Nasal Tissue Culture Models to Whole Cigarette Smoke
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The Risk of Nonunion in Smokers Revisited: A Systematic Review and Meta-Analysis.
Ravi S Nunna1, Philip B Ostrov2, Darius Ansari2
17287Swedish Neuroscience Institute, Seattle, WA, USA.
Global Spine Journal
|September 29, 2021
Summary
Smoking significantly increases the risk of nonunion after spinal fusion surgery. This meta-analysis confirms that tobacco use elevates nonunion rates regardless of fusion specifics.
Area of Science:
- Orthopedic Surgery
- Spine Fusion
- Smoking Cessation
Background:
- Nonunion is a significant complication following spinal fusion.
- Tobacco smoking is a known risk factor for poor surgical outcomes.
- The precise impact of smoking on spinal fusion nonunion requires comprehensive evaluation.
Purpose of the Study:
- To systematically review and meta-analyze the effect of tobacco smoking on the risk of nonunion after spinal fusion.
Main Methods:
- Systematic search of multiple databases (Medline, Embase, Cochrane) up to December 2020.
- Inclusion of cohort studies comparing smokers and nonsmokers undergoing spinal fusion.
- Risk of bias assessment and GRADE criteria for strength of evidence; random effects model for meta-analysis.
Main Results:
- Twenty studies involving 3009 participants were analyzed.
- Smoking was associated with a 1.91-fold increased risk of nonunion post-spinal fusion.
- Increased nonunion risk was observed with both allograft and autograft, and for single and multilevel fusions.
Conclusions:
- Smoking status presents a global risk for spinal fusion nonunion.
- Further high-quality studies are needed to develop smoking-specific treatment guidelines.
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