{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T13:13:11Z","timestamp":1793365991718,"version":"4.5.0"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Smoking has been shown to negatively impact spinal health, as well as the outcomes of spinal fusion. Published reports show conflicting data regarding whether smoking negatively impacts patient outcomes following lumbar decompression. The objective of this study was to investigate whether smoking affects the outcomes of patients undergoing lumbar decompression for spinal stenosis or herniated disc.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The Quality Outcomes Database was queried for patients with spinal stenosis or lumbar disc herniation who underwent one- or two-level lumbar decompression without fusion. All patients had preoperative and 12-month outcome measures and were divided into groups of nonsmokers and current smokers. Outcomes were compared between the two groups, as well as the percentage of patients reaching the minimal clinically important difference (MCID) threshold for numeric rating scale (NRS) back and leg pain scores and the Oswestry Disability Index (ODI).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Of 17,271 patients, 14,233 were nonsmokers and 3038 were current smokers. Smokers had worse baseline NRS back and leg pain, ODI, and EQ-5D scores and experienced slightly less improvement in all measures following lumbar decompression (p \u2264 0.009), although changes were largely similar, and a high percentage of patients achieved the MCID thresholds for NRS back pain (78% nonsmokers vs 75% smokers), NRS leg pain (79% nonsmokers vs 73% smokers), and ODI (74% nonsmokers vs 68% smokers). Comparison of propensity-matched cohorts did not identify any difference in outcomes in smokers versus nonsmokers.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>In patients undergoing lumbar decompression for spinal stenosis or herniated disc, smokers demonstrated slightly less improvement in outcomes compared with nonsmokers, and a high proportion of both groups achieved meaningful improvement with surgery. While smoking cessation should be strongly encouraged in all patients, lumbar decompression procedures for spinal stenosis and herniated disc should not be denied to smokers.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.7.spine24138","type":"journal-article","created":{"date-parts":[[2024,10,19]],"date-time":"2024-10-19T02:03:12Z","timestamp":1729303392000},"page":"1-6","source":"Crossref","is-referenced-by-count":2,"title":["The impact of smoking on patient-reported outcomes following lumbar decompression: an analysis of the Quality Outcomes Database"],"prefix":"10.3171","author":[{"given":"Mladen","family":"Djurasovic","sequence":"first","affiliation":[{"name":"Norton Leatherman Spine Center, Louisville, Kentucky;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Kirk","family":"Owens","sequence":"additional","affiliation":[{"name":"Norton Leatherman Spine Center, Louisville, Kentucky;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah Y.","family":"Carreon","sequence":"additional","affiliation":[{"name":"Norton Leatherman Spine Center, Louisville, Kentucky;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey L.","family":"Gum","sequence":"additional","affiliation":[{"name":"Norton Leatherman Spine Center, Louisville, Kentucky;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica F.","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Glassman","sequence":"additional","affiliation":[{"name":"Norton Leatherman Spine Center, Louisville, Kentucky;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"10","key":"b1","series-title":"Spine J","first-page":"1586","article-title":"Recent trends in Medicare utilization and reimbursement for lumbar spine fusion and discectomy procedures","volume":"20","author":"Lopez CD","year":"2020","unstructured":"Lopez CD, Boddapati V, Lombardi JM,  Recent trends in Medicare utilization and reimbursement for lumbar spine fusion and discectomy procedures. Spine J. 2020;20(10):1586\u20131594."},{"issue":"2","key":"b2","series-title":"Spine (Phila Pa 1976)","first-page":"63","article-title":"Long-term outcomes of lumbar spinal stenosis: eight-year results of the Spine Patient Outcomes Research Trial (SPORT)","volume":"40","author":"Lurie JD","year":"2015","unstructured":"Lurie JD, Tosteson TD, Tosteson A,  Long-term outcomes of lumbar spinal stenosis: eight-year results of the Spine Patient Outcomes Research Trial (SPORT). Spine (Phila Pa 1976). 2015;40(2):63\u201376."},{"issue":"9","key":"b3","series-title":"Spine (Phila Pa 1976)","first-page":"1015","article-title":"1991 Volvo Award in clinical sciences. Smoking and lumbar intervertebral disc degeneration: an MRI study of identical twins","volume":"16","author":"Batti\u00e9 MC","year":"1991","unstructured":"Batti\u00e9 MC, Videman T, Gill K,  1991 Volvo Award in clinical sciences. Smoking and lumbar intervertebral disc degeneration: an MRI study of identical twins. Spine (Phila Pa 1976). 1991;16(9):1015\u20131021."},{"key":"b4","series-title":"Brain Spine","first-page":"100916","article-title":"Smoking and degenerative spinal disease: a systematic review","volume":"2","author":"Rajesh N","year":"2022","unstructured":"Rajesh N, Moudgil-Joshi J, Kaliaperumal C. Smoking and degenerative spinal disease: a systematic review. Brain Spine. 2022;2:100916."},{"issue":"5","key":"b5","series-title":"J Spinal Disord","first-page":"369","article-title":"Comparison of smoking habits between patients with surgically confirmed herniated lumbar and cervical disc disease and controls","volume":"7","author":"An HS","year":"1994","unstructured":"An HS, Silveri CP, Simpson JM,  Comparison of smoking habits between patients with surgically confirmed herniated lumbar and cervical disc disease and controls. J Spinal Disord. 1994;7(5):369\u2013373."},{"issue":"14","key":"b6","series-title":"Spine (Phila Pa 1976)","first-page":"1549","article-title":"The effect of nicotine on spinal fusion","volume":"20","author":"Silcox DH III","year":"1995","unstructured":"Silcox DH III, Daftari T, Boden SD, Schimandle JH, Hutton WC, Whitesides TE Jr. The effect of nicotine on spinal fusion. Spine (Phila Pa 1976). 1995;20(14):1549\u20131553."},{"issue":"20","key":"b7","series-title":"Spine (Phila Pa 1976)","first-page":"2608","article-title":"The effect of cigarette smoking and smoking cessation on spinal fusion","volume":"25","author":"Glassman SD","year":"2000","unstructured":"Glassman SD, Anagnost SC, Parker A, Burke D, Johnson JR, Dimar JR. The effect of cigarette smoking and smoking cessation on spinal fusion. Spine (Phila Pa 1976). 2000;25(20):2608\u20132615."},{"issue":"1","key":"b8","series-title":"Clin Spine Surg","first-page":"E45","article-title":"How does smoking influence patient-reported outcomes in patients after lumbar fusion?","volume":"34","author":"Goyal DKC","year":"2021","unstructured":"Goyal DKC, Divi SN, Bowles DR,  How does smoking influence patient-reported outcomes in patients after lumbar fusion? Clin Spine Surg. 2021;34(1):E45\u2013E50."},{"issue":"2","key":"b9","series-title":"J Bone Joint Surg Br","first-page":"178","article-title":"Effect of smoking on early complications after elective orthopaedic surgery","volume":"85","author":"M\u00f8ller AM","year":"2003","unstructured":"M\u00f8ller AM, Pedersen T, Villebro N, Munksgaard A. Effect of smoking on early complications after elective orthopaedic surgery. J Bone Joint Surg Br. 2003;85(2):178\u2013181."},{"issue":"4","key":"b10","series-title":"Int J Spine Surg","first-page":"29","article-title":"The effect of smoking on spinal fusion","volume":"11","author":"Berman D","year":"2017","unstructured":"Berman D, Oren JH, Bendo J, Spivak J. The effect of smoking on spinal fusion. Int J Spine Surg. 2017;11(4):29."},{"issue":"5","key":"b11","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Quality Outcomes Database Spine Care Project 2012-2020: milestones achieved in a collaborative North American outcomes registry to advance value-based spine care and evolution to the American Spine Registry","volume":"48","author":"Asher AL","year":"2020","unstructured":"Asher AL, Knightly J, Mummaneni PV,  Quality Outcomes Database Spine Care Project 2012-2020: milestones achieved in a collaborative North American outcomes registry to advance value-based spine care and evolution to the American Spine Registry. Neurosurg Focus. 2020;48(5):E2."},{"issue":"22 Suppl 1","key":"b12","series-title":"Spine (Phila Pa 1976)","first-page":"S106","article-title":"The National Neurosurgery Quality and Outcomes Database (N2QOD): a collaborative North American outcomes registry to advance value-based spine care","volume":"39","author":"Asher AL","year":"2014","unstructured":"Asher AL, Speroff T, Dittus RS,  The National Neurosurgery Quality and Outcomes Database (N2QOD): a collaborative North American outcomes registry to advance value-based spine care. Spine (Phila Pa 1976). 2014;39(22 Suppl 1):S106\u2013S116."},{"issue":"22","key":"b13","series-title":"Spine (Phila Pa 1976)","first-page":"2940","article-title":"The Oswestry Disability Index","volume":"25","author":"Fairbank JC","year":"2000","unstructured":"Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000;25(22):2940\u20132952."},{"issue":"3","key":"b14","series-title":"Health Policy","first-page":"199","article-title":"EuroQol\u2014a new facility for the measurement of health-related quality of life","volume":"16","author":"EuroQol Group","year":"1990","unstructured":"EuroQol Group. EuroQol\u2014a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199\u2013208."},{"issue":"6","key":"b15","series-title":"Spine J","first-page":"968","article-title":"Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales","volume":"8","author":"Copay AG","year":"2008","unstructured":"Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY. Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. Spine J. 2008;8(6):968\u2013974."},{"issue":"3","key":"b16","series-title":"Spine (Phila Pa 1976)","first-page":"201","article-title":"Do former smokers exhibit a distinct profile before and after lumbar spine surgery?","volume":"43","author":"Jazini E","year":"2018","unstructured":"Jazini E, Glassman SD, Bisson EF, Potts EA, Carreon LY. Do former smokers exhibit a distinct profile before and after lumbar spine surgery? Spine (Phila Pa 1976). 2018;43(3):201\u2013206."},{"key":"b17","series-title":"BMC Public Health","first-page":"203","article-title":"Smoking and health-related quality of life in English general population: implications for economic evaluations","volume":"12","author":"Vogl M","year":"2012","unstructured":"Vogl M, Wenig CM, Leidl R, Pokhrel S. Smoking and health-related quality of life in English general population: implications for economic evaluations. BMC Public Health. 2012;12:203."},{"issue":"5","key":"b18","series-title":"Global Spine J","first-page":"727","article-title":"Does smoking affect short-term patient-reported outcomes after lumbar decompression?","volume":"11","author":"Goyal DKC","year":"2021","unstructured":"Goyal DKC, Divi SN, Bowles DR,  Does smoking affect short-term patient-reported outcomes after lumbar decompression? Global Spine J. 2021;11(5):727\u2013732."},{"key":"b19","series-title":"SICOT J","first-page":"65","article-title":"Does smoking affect the outcomes of lumbar decompression surgery?","volume":"3","author":"Mehta R","year":"2017","unstructured":"Mehta R, Sharma H. Does smoking affect the outcomes of lumbar decompression surgery? SICOT J. 2017;3:65."},{"key":"b20","series-title":"Clin Neurol Neurosurg","first-page":"12","article-title":"Influence of smoking status at time of surgery for herniated lumbar disk on postoperative pain and health-related quality of life","volume":"122","author":"Stienen MN","year":"2014","unstructured":"Stienen MN, Smoll NR, Hildebrandt G, Schaller K, Gautschi OP. Influence of smoking status at time of surgery for herniated lumbar disk on postoperative pain and health-related quality of life. Clin Neurol Neurosurg. 2014;122:12\u201319."},{"key":"b21","series-title":"Clin Neurol Neurosurg","first-page":"87","article-title":"Short- and long-term effects of smoking on pain and health-related quality of life after non-instrumented lumbar spine surgery","volume":"142","author":"Stienen MN","year":"2016","unstructured":"Stienen MN, Joswig H, Smoll NR,  Short- and long-term effects of smoking on pain and health-related quality of life after non-instrumented lumbar spine surgery. Clin Neurol Neurosurg. 2016;142:87\u201392."},{"issue":"13","key":"b22","series-title":"Spine (Phila Pa 1976)","first-page":"1059","article-title":"Smokers show less improvement than nonsmokers two years after surgery for lumbar spinal stenosis: a study of 4555 patients from the Swedish spine register","volume":"36","author":"Sand\u00e9n B","year":"2011","unstructured":"Sand\u00e9n B, F\u00f6rsth P, Micha\u00eblsson K. Smokers show less improvement than nonsmokers two years after surgery for lumbar spinal stenosis: a study of 4555 patients from the Swedish spine register. Spine (Phila Pa 1976). 2011;36(13):1059\u20131064."},{"issue":"7","key":"b23","series-title":"Acta Neurochir (Wien)","first-page":"1157","article-title":"Does daily tobacco smoking affect outcomes after microdecompression for degenerative central lumbar spinal stenosis? A multicenter observational registry-based study","volume":"157","author":"Gulati S","year":"2015","unstructured":"Gulati S, Nordseth T, Nerland US,  Does daily tobacco smoking affect outcomes after microdecompression for degenerative central lumbar spinal stenosis? A multicenter observational registry-based study. Acta Neurochir (Wien). 2015;157(7):1157\u20131164."},{"issue":"3","key":"b24","series-title":"J Neurosurg Spine","first-page":"288","article-title":"Smoking as an independent predictor of reoperation after lumbar laminectomy: a study of 500 cases","volume":"22","author":"Bydon M","year":"2015","unstructured":"Bydon M, Macki M, De la Garza-Ramos R,  Smoking as an independent predictor of reoperation after lumbar laminectomy: a study of 500 cases. J Neurosurg Spine. 2015;22(3):288\u2013293."},{"issue":"6","key":"b25","series-title":"Clin Orthop Relat Res","first-page":"1920","article-title":"What are the long-term predictors of outcomes for lumbar disc herniation? A randomized and observational study","volume":"473","author":"Kerr D","year":"2015","unstructured":"Kerr D, Zhao W, Lurie JD. What are the long-term predictors of outcomes for lumbar disc herniation? A randomized and observational study. Clin Orthop Relat Res. 2015;473(6):1920\u20131930."},{"issue":"5","key":"b26","series-title":"Neurosurg Rev","first-page":"1297","article-title":"The impact of obesity and smoking on young individuals suffering from lumbar disc herniation: a retrospective analysis of 97 cases","volume":"43","author":"Lener S","year":"2020","unstructured":"Lener S, Wipplinger C, Hartmann S, Thom\u00e9 C, Tschugg A. The impact of obesity and smoking on young individuals suffering from lumbar disc herniation: a retrospective analysis of 97 cases. Neurosurg Rev. 2020;43(5):1297\u20131303."},{"issue":"3","key":"b27","series-title":"Eur Spine J","first-page":"604","article-title":"Overweight and smoking promote recurrent lumbar disk herniation after discectomy","volume":"31","author":"Siccoli A","year":"2022","unstructured":"Siccoli A, Staartjes VE, Klukowska AM, Muizelaar JP, Schr\u00f6der ML. Overweight and smoking promote recurrent lumbar disk herniation after discectomy. Eur Spine J. 2022;31(3):604\u2013613."},{"issue":"7","key":"b28","series-title":"Global Spine J","first-page":"832","article-title":"Clinical outcomes of decompression alone versus and decompression and fusion for first episode recurrent disc herniation","volume":"10","author":"Carreon LY","year":"2020","unstructured":"Carreon LY, Bisson EF, Potts EA,  Clinical outcomes of decompression alone versus and decompression and fusion for first episode recurrent disc herniation. Global Spine J. 2020;10(7):832\u2013836."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/aop\/article-10.3171-2024.7.SPINE24138\/article-10.3171-2024.7.SPINE24138.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/aop\/article-10.3171-2024.7.SPINE24138\/article-10.3171-2024.7.SPINE24138.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/aop\/article-10.3171-2024.7.SPINE24138\/article-10.3171-2024.7.SPINE24138.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,28]],"date-time":"2024-12-28T02:03:51Z","timestamp":1735351431000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/aop\/article-10.3171-2024.7.SPINE24138\/article-10.3171-2024.7.SPINE24138.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,1]]},"references-count":28,"URL":"https:\/\/doi.org\/10.3171\/2024.7.spine24138","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2024,10,1]]}}}