Smokers who need spinal-fusion surgery in their necks may be in for an unfortunate surprise: their habit, already associated with other health problems, may also make the surgery less successful, a new study reports. Researchers, writing in a recent Journ

There may be a hidden benefit, however, for smokers who need that extra nudge to quit. While much of tobacco's damage takes a long time to heal, reducing the risk for fusion patients may be as simple as giving up smoking before the operation. "It's actually the nicotine itself that inhibits bone healing," said Dr. Alan S. Hilibrand of Thomas Jefferson University and the Rothman Institute in Philadelphia. And nicotine, he said, does not linger long in the body. The researchers based their findings on a study of 190 patients with herniated disks or spondylosis, a disease in which excess bone forms around the disks of the spine. The patients were treated at Case Western Reserve University in Cleveland, where the study began. More than 100,000 cervical fusion operations are performed in the United States each year. The study found that 81 percent of nonsmokers re-established a solid bone connection in the month after surgery, compared with 62 percent of smokers. Good or excellent overall results (assessed by pain levels and ability to return to normal daily living) were reported for 88 percent of nonsmokers and 76 percent of smokers.

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