Effect of Smoking on Motor Recovery After Cervical American Spinal Injury Association Grade D Traumatic Spinal Cord Injury

International Journal of Spine Surgery, 2022 · DOI: 10.14444/8411 · Published: November 21, 2022

Spinal Cord Injury Pharmacology Neurology

Simple Explanation

This study investigates the impact of smoking on motor recovery after traumatic spinal cord injury (TSCI). It compares motor score improvement and overall motor scores between smokers and nonsmokers after surgical management of ASIA grade D cervical TSCI. The researchers found that smokers with TSCI had worse motor score improvement at 1 year and worse overall total motor scores at 1 year compared to nonsmokers, even after accounting for other factors that could influence motor function. The study suggests that smoking has a direct toxic effect on spinal cord recovery, highlighting the importance of aggressive smoking cessation interventions for patients with TSCI to maximize their motor outcomes.

Study Duration

2009-2016

Participants

152 patients (121 smokers and 31 nonsmokers) with ASIA grade D cervical TSCI

Evidence Level

Level 3

Key Findings

1
Smokers had worse improvement in motor score at 1 year compared to nonsmokers (4.61 vs 7.99, P = 0.019).
2
Smokers had worse overall total motor score at 1 year compared with nonsmokers (90.0 vs 94.0, P = 0.018).
3
Smoking is a significant predictor of diminished motor recovery after TSCI, even when considering other factors like age and rehabilitation length of stay.

Research Summary

This study examined the effect of smoking on motor recovery in patients with American Spinal Injury Association (ASIA) grade D cervical traumatic spinal cord injury (TSCI). The research found that patients who smoked had diminished motor recovery compared to non-smokers one year after the injury. The authors concluded that aggressive smoking cessation is crucial for maximizing motor outcomes in TSCI patients.

Practical Implications

Smoking Cessation Programs

Implement aggressive smoking cessation programs for patients with TSCI, including counseling, medication, and behavioral interventions.

Provider Education

Educate healthcare providers on the importance of emphasizing smoking cessation to TSCI patients early and often.

Social Support

Encourage healthcare provider and social support for TSCI patients to facilitate smoking cessation.

Study Limitations

1
Retrospective nature of the data leads to inherent biases.
2
Smoking data did not include information on packs per day or duration of smoking.
3
50% 1-year loss to follow-up rate, potentially increasing selection bias.

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