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The present study aimed to compare the clinical and radiological outcomes of smokers to those of nonsmokers following CDA.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors retrospectively reviewed the records of consecutive patients who had undergone 1- or 2-level CDA for cervical disc herniation or spondylosis and had a minimum 2-year follow-up. All patients were grouped into a smoking group, which consisted of those who had consumed cigarettes within 6 months prior to the CDA surgery, or a nonsmoking group, which consisted of those who had not consumed cigarettes at all or within 6 months of the CDA. Clinical outcomes were evaluated according to the visual analog scale for neck and arm pain, Neck Disability Index, Japanese Orthopaedic Association Scale, and Nurick Scale at each time point of evaluation. Radiological outcomes were assessed using radiographs and CT for multiple parameters, including segmental range of motion (ROM), neutral lordotic curve, and presence of heterotopic ossification (HO).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 109 patients completed at least 2 years of follow-up and were analyzed (mean follow-up 42.3 months). There were 89 patients in the nonsmoking group and 20 in the smoking group. The latter group was younger and predominantly male (both p &lt; 0.05) compared to the nonsmoking group. The two groups had similar improvements in all clinical outcomes after CDA compared to preoperatively. Radiological evaluations were also very similar between the two groups, except for two factors. The smoking group had well-preserved segmental ROM after CDA at an average of 8.1\u00b0 (both pre- and postoperation). However, while the nonsmoking group remained mobile, segmental ROM decreased significantly (8.2\u00b0 to 6.9\u00b0, p &lt; 0.05) after CDA. There was a trend toward more HO development in the nonsmoking group than in the smoking group, but the difference was without significance (59.6% vs 50.0%, p = 0.43).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>During an average 3.5 years of follow-up after 1- and 2-level CDA, cigarette smokers and nonsmokers had similar improvements in clinical outcomes. Moreover, segmental mobility was slightly better preserved in smokers. Since smoking status did not negatively impact outcomes, CDA may be a reasonable option for selected patients who have smoked.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2018.7.spine18634","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T01:11:53Z","timestamp":1551229913000},"page":"168-174","source":"Crossref","is-referenced-by-count":18,"title":["Effects of smoking on cervical disc arthroplasty"],"prefix":"10.3171","volume":"30","author":[{"given":"Tsung-Hsi","family":"Tu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"School of Medicine, National Yang-Ming University;"},{"name":"Institute of Biomedical Sciences, Academia Sinica, and National Yang-Ming University;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao-Hung","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"School of Medicine, National Yang-Ming University;"},{"name":"Department of Neurological Surgery, University of Washington, Seattle, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Cheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"School of Medicine, National Yang-Ming University;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Yu","family":"Fay","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"School of Medicine, National Yang-Ming University;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrich","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"School of Medicine, National Yang-Ming University;"},{"name":"Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jau-Ching","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"School of Medicine, National Yang-Ming University;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Orthopedics","doi-asserted-by":"publisher","first-page":"90","DOI":"10.3928\/01477447-20100104-14","article-title":"Impact of passive smoking on the bones of rats","volume":"33","author":"Ajiro Y","year":"2010","unstructured":"Ajiro Y, Tokuhashi Y, Matsuzaki H, Nakajima S, Ogawa T: Impact of passive smoking on the bones of rats. 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