{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:57:37Z","timestamp":1778219857771,"version":"3.51.4"},"reference-count":82,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n It is not clear whether smoking impacts patient-reported outcomes (PROs) in patients with cervical spondylotic myelopathy (CSM). The aim of this study was to explore the impact of smoking status on baseline symptom severity and the rate of achieving satisfaction and the minimal clinically important differences (MCIDs) for PROs in patients with CSM.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n This study was an analysis of the prospective Quality Outcomes Database CSM module. Patients aged\n \u2265<\/jats:italic>\n 18 years diagnosed with primary CSM who underwent elective surgery were included. PROs (visual analog scale [VAS] neck and arm pain, Neck Disability Index [NDI], modified Japanese Orthopaedic Association [mJOA], and EQ-5D scores and North American Spine Society [NASS] patient satisfaction) were collected at baseline and 24 months of follow-up.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Of the 1141 patients with CSM, 202 (17.7%) were smokers and 939 (82.3%) were nonsmokers. Compared with the nonsmokers, smokers were younger (56.3 \u00b1 11.3 years vs 61.5 \u00b1 11.7 years, p < 0.01) and had a lower BMI (29.3 \u00b1 6.8 vs 30.3 \u00b1 6.3, p = 0.04). A higher proportion of smokers had depression, anxiety, and chronic obstructive pulmonary disease (all p < 0.01). At baseline, smokers had worse pain (VAS neck pain score: 6.0 \u00b1 3.2 vs 5.1 \u00b1 3.3; VAS arm pain score: 5.7 \u00b1 3.2 vs 4.7 \u00b1 3.5), disability (NDI score: 45.2 \u00b1 20.0 vs 37.1 \u00b1 20.6), myelopathy (mJOA score: 11.5 \u00b1 2.9 vs 12.2 \u00b1 2.8), and quality of life (EQ-5D score: 0.51 \u00b1 0.23 vs 0.57 \u00b1 0.22) (all p < 0.01). At the 24-month follow-up, a higher proportion of smokers achieved the MCID in mJOA (69.4% vs 56.6%, p < 0.01) compared with nonsmokers. However, after accounting for significant covariates, there was no significant difference in the baseline disease severity. There was also no difference between the PROs at the 24-month follow-up. The two groups also achieved similar MCIDs for most PROs and were similarly satisfied (NASS score of 1 or 2: smoker 81.2% vs nonsmoker 84.6%, p = 0.29) 24 months after surgery.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Smokers and nonsmokers with CSM had similar baseline disease severity and 24-month PROs. They also achieved similar rates of MCIDs for PROs and satisfaction after surgery. Numerous previous studies have documented the association between tobacco usage and inferior clinical outcomes after spine surgery. However, in the context of severe and debilitating spinal disorders such as cervical myelopathy, meaningful and impactful improvements are still seen in properly selected patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2024.10.spine24744","type":"journal-article","created":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T21:06:54Z","timestamp":1739567214000},"page":"533-540","source":"Crossref","is-referenced-by-count":2,"title":["Does smoking status affect baseline symptom severity and patient-reported outcomes and satisfaction in patients with cervical myelopathy at 24 months? A Quality Outcomes Database study"],"prefix":"10.3171","volume":"42","author":[{"given":"Christine","family":"Park","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deb","family":"Bhowmick","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raj Swaroop","family":"Lavadi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica F.","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony L.","family":"Asher","sequence":"additional","affiliation":[{"name":"Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domagoj","family":"Coric","sequence":"additional","affiliation":[{"name":"Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric A.","family":"Potts","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Indianapolis, Indiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin T.","family":"Foley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee, Semmes Murphey Neurologic and Spine Institute, Memphis, Tennessee;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee, Semmes Murphey Neurologic and Spine Institute, Memphis, Tennessee;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Miami, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai-Ming","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weill Cornell Medical Center, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael S.","family":"Virk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weill Cornell Medical Center, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Knightly","sequence":"additional","affiliation":[{"name":"Atlantic Neurosurgical Specialists, Morristown, New Jersey;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Meyer","sequence":"additional","affiliation":[{"name":"Atlantic Neurosurgical Specialists, Morristown, New Jersey;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheerag D.","family":"Upadhyaya","sequence":"additional","affiliation":[{"name":"Marion Bloch Neuroscience Institute, Saint Luke\u2019s Health System, Kansas City, Missouri;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark E.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander J.","family":"Schupper","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan S.","family":"Uribe","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis M.","family":"Tumial\u00e1n","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay D.","family":"Turner","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dean","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regis W.","family":"Haid","sequence":"additional","affiliation":[{"name":"Atlanta Brain and Spine Care, Atlanta, Georgia; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praveen V.","family":"Mummaneni","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oren N.","family":"Gottfried","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Drug Alcohol Rev","first-page":"597","article-title":"Reducing the burden of smoking world-wide: effectiveness of interventions and their coverage","volume":"25","author":"Jha P","year":"2006","unstructured":"Jha P, Chaloupka FJ, Corrao M, Jacob B. 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MMWR Morb Mortal Wkly Rep. 2018;67(2):53\u201359."},{"key":"b4","series-title":"Immun Ageing","first-page":"10","article-title":"Smoking, health and ageing","volume":"5","author":"Nicita-Mauro V","year":"2008","unstructured":"Nicita-Mauro V, Basile G, Maltese G, Nicita-Mauro C, Gangemi S, Caruso C. Smoking, health and ageing. Immun Ageing. 2008;5:10."},{"issue":"6","key":"b5","series-title":"JAMA","first-page":"566","article-title":"Treatment of tobacco smoking: a review","volume":"327","author":"Rigotti NA","year":"2022","unstructured":"Rigotti NA, Kruse GR, Livingstone-Banks J, Hartmann-Boyce J. Treatment of tobacco smoking: a review. JAMA. 2022;327(6):566\u2013577."},{"issue":"10","key":"b6","series-title":"Int J Environ Res Public Health","first-page":"2244","article-title":"Tobacco health risk awareness among socially disadvantaged people\u2014a crucial tool for smoking cessation","volume":"15","author":"Milcarz M","year":"2018","unstructured":"Milcarz M, Polanska K, Bak-Romaniszyn L, Kaleta D. Tobacco health risk awareness among socially disadvantaged people\u2014a crucial tool for smoking cessation. Int J Environ Res Public Health. 2018;15(10):2244."},{"issue":"Suppl 1","key":"b7","series-title":"J Adv Pharm Technol Res","first-page":"S217","article-title":"Awareness on ill effects of tobacco usage among tobacco users","volume":"13","author":"Nivethitha R","year":"2022","unstructured":"Nivethitha R, Leelavathi L. Awareness on ill effects of tobacco usage among tobacco users. 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Surg Neurol Int. 2021;12:118."},{"issue":"10","key":"b12","series-title":"Clin Spine Surg","first-page":"E493","article-title":"Impact of tobacco smoking on outcomes after posterior decompression surgery in patients with cervical spondylotic myelopathy: a retrospective multicenter study","volume":"33","author":"Nagoshi N","year":"2020","unstructured":"Nagoshi N, Kono H, Tsuji O, Impact of tobacco smoking on outcomes after posterior decompression surgery in patients with cervical spondylotic myelopathy: a retrospective multicenter study. Clin Spine Surg. 2020;33(10):E493\u2013E498."},{"issue":"18","key":"b13","series-title":"Spine (Phila Pa 1976)","first-page":"1391","article-title":"The effect of smoking on spinal cord healing following surgical treatment of cervical myelopathy","volume":"40","author":"Kusin DJ","year":"2015","unstructured":"Kusin DJ, Ahn UM, Ahn NU. The effect of smoking on spinal cord healing following surgical treatment of cervical myelopathy. 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J Orthop Surg Res. 2021;16(1):75."},{"issue":"24","key":"b16","series-title":"J Bone Joint Surg Am","first-page":"2038","article-title":"A clinical prediction rule for functional outcomes in patients undergoing surgery for degenerative cervical myelopathy: analysis of an international prospective multicenter data set of 757 subjects","volume":"97","author":"Tetreault L","year":"2015","unstructured":"Tetreault L, Kopjar B, C\u00f4t\u00e9 P, Arnold P, Fehlings MG. A clinical prediction rule for functional outcomes in patients undergoing surgery for degenerative cervical myelopathy: analysis of an international prospective multicenter data set of 757 subjects. J Bone Joint Surg Am. 2015;97(24):2038\u20132046."},{"issue":"4","key":"b17","series-title":"J Neurosurg Spine","first-page":"568","article-title":"Association of \u2265 12 months of delayed surgical treatment for cervical myelopathy with worsened postoperative outcomes: a multicenter analysis of the Quality Outcomes Database","volume":"36","author":"Asuzu DT","year":"2021","unstructured":"Asuzu DT, Yun JJ, Alvi MA, Association of \u2265 12 months of delayed surgical treatment for cervical myelopathy with worsened postoperative outcomes: a multicenter analysis of the Quality Outcomes Database. 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J Neurosurg Spine. 2022;37(1):41\u201348."},{"issue":"3","key":"b20","series-title":"J Neurosurg Spine","first-page":"339","article-title":"Differences in postoperative quality of life in young, early elderly, and late elderly patients undergoing surgical treatment for degenerative cervical myelopathy","volume":"37","author":"Croci DM","year":"2022","unstructured":"Croci DM, Sherrod B, Alvi MA, Differences in postoperative quality of life in young, early elderly, and late elderly patients undergoing surgical treatment for degenerative cervical myelopathy. 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An analysis of the Quality Outcomes Database cervical spondylotic myelopathy cohort. Neurosurg Focus. 2023;55(3):E2."},{"issue":"5","key":"b24","series-title":"J Neurosurg Spine","first-page":"530","article-title":"Characteristics of patients who return to work after undergoing surgery for cervical spondylotic myelopathy: a Quality Outcomes Database study","volume":"38","author":"Bergin SM","year":"2023","unstructured":"Bergin SM, Michalopoulos GD, Shaffrey CI, Characteristics of patients who return to work after undergoing surgery for cervical spondylotic myelopathy: a Quality Outcomes Database study. J Neurosurg Spine. 2023;38(5):530\u2013539."},{"issue":"5","key":"b25","series-title":"J Neurosurg Spine","first-page":"758","article-title":"Determining the time frame of maximum clinical improvement in surgical decompression for cervical spondylotic myelopathy when stratified by preoperative myelopathy severity: a cervical Quality Outcomes Database study","volume":"37","author":"Berlin C","year":"2022","unstructured":"Berlin C, Marino AC, Mummaneni PV, Determining the time frame of maximum clinical improvement in surgical decompression for cervical spondylotic myelopathy when stratified by preoperative myelopathy severity: a cervical Quality Outcomes Database study. 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J Neurosurg Spine. 2022;38(1):42\u201355."},{"issue":"1","key":"b28","series-title":"J Neurosurg Spine","first-page":"11","article-title":"Do comorbid self-reported depression and anxiety influence outcomes following surgery for cervical spondylotic myelopathy?","volume":"39","author":"Chan AK","year":"2023","unstructured":"Chan AK, Shaffrey CI, Park C, Do comorbid self-reported depression and anxiety influence outcomes following surgery for cervical spondylotic myelopathy? J Neurosurg Spine. 2023;39(1):11\u201327."},{"issue":"6","key":"b29","series-title":"Neurosurg Focus","first-page":"E5","article-title":"Which supervised machine learning algorithm can best predict achievement of minimum clinically important difference in neck pain after surgery in patients with cervical myelopathy? 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JAMA. 2015;314(18):1966\u20131967."},{"issue":"9","key":"b37","series-title":"Eur Spine J","first-page":"2386","article-title":"Trends analysis of surgical procedures for cervical degenerative disc disease and myelopathy in patients with tobacco use disorder","volume":"26","author":"Grisdela P Jr","year":"2017","unstructured":"Grisdela P Jr, Buser Z, D\u2019Oro A, Paholpak P, Liu JC, Wang JC. Trends analysis of surgical procedures for cervical degenerative disc disease and myelopathy in patients with tobacco use disorder. 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