The Impact of Smoking on Radiological Outcomes in Patients After Total Arthroplasty of the Cervical Intervertebral Discs
https://doi.org/10.20862/0042-4676-2020-101-5-268-275
Abstract
Objective: to investigate the impact of smoking on radiological outcomes in patients after one- and two-level total arthroplasty (ТА) of the cervical intervertebral discs.
Material and methods. A single-center retrospective observational cohort study was performed. The study included 127 medical records of patients who had undergone one- or two-level TA of the cervical intervertebral discs for their degenerative disease. The medical records were divided into two groups: 32 smokers and 95 nonsmokers.
Results. No statistically significant differences were found in the values of cervical lordosis and the movement amplitude of the operated segments in the postoperative period. Comparing the values of the movement amplitude of the operated segments in the group of smoking patients demonstrated significant pre- and postoperative differences in the values of the above radiological parameter (p = 0.017). Comparing the rates of loss of segmental motion of the operated segments and the incidence of heterotopic ossification did not reveal any significant differences. Analysis of Kaplan-Meier curves showed no statistically significant differences between the types of implants used in smoking patients.
Conclusion. Smoking has no statistically significant impact on radiological outcomes in patients after one- or two-level ТА of the cervical intervertebral discs.
About the Authors
I. A. StepanovRussian Federation
Ivan A. Stepanov - Postgraduate, Chair of Neurosurgery and Innovative Medicine.
Ul. Krasnogo Vosstaniya, 1, Irkutsk, 664003
V. А. Byvaltsev
Russian Federation
Vadim A. Byvaltsev - Dr. Med. Sc., Professor, Chief of the Chair of Neurosurgery and Innovative Medicine, IrSMU; Head of the Center for Neurosurgery, Railway Clinical Hospital on the Irkutsk-Passazhirskiy station, OJSC “RRM”; Deputy Director for Innovation and International Activities, Irkutsk Scientific Center for Surgery and Traumatology; Professor of the Chair of Traumatology, Orthopedics and Neurosurgery, IrSM APE.
Ul. Krasnogo Vosstaniya, 1, Irkutsk, 664003; ul. Botkina, 10, Irkutsk, 664005; ul. Bortsov Revolyutsii, 1, Irkutsk, 664003; Yubileynyy microdistrict, 100, Irkutsk, 664049
M. A. Aliyev
Russian Federation
Marat A. Aliyev - Cand. Med. Sc., Doctoral Candidate, Chair of Neurosurgery and Innovative Medicine.
Ul. Krasnogo Vosstaniya, 1, Irkutsk, 664003
B. M. Aglakov
Russian Federation
Bakhyt M. Aglakov - Postgraduate, Chair of Neurosurgery and Innovative Medicine.
Ul. Krasnogo Vosstaniya, 1, Irkutsk, 664003
B. R. Yussupov
Russian Federation
Bobur R. Yussupov - Postgraduate, Chair of Neurosurgery and Innovative Medicine.
Ul. Krasnogo Vosstaniya, 1, Irkutsk, 664003
Yu. Ya. Pestryakov
Russian Federation
Yuriy Ya. Pestryakov - Cand. Med. Sc., Doctoral Candidate, Chair of Neurosurgery and Innovative Medicine.
Ul. Krasnogo Vosstaniya, 1, Irkutsk, 664003
V. V. Shepelev
Russian Federation
Valeriy V. Shepelev - Cand. Med. Sc., Doctoral Candidate, Chair of Neurosurgery and Innovative Medicine.
Ul. Krasnogo Vosstaniya, 1, Irkutsk, 664003
References
1. de Rooij JD, Gadjradj PS, Soria van Hoeve JS, Harhangi BS. Anterior cervical discectomy without fusion for a symptomatic cervical disk herniation. Acta Neurochir (Wien). 2017; 159(7): 1283-7. doi: 10.1007/s00701-017-3189-x
2. Ofluoglu AE, Erdogan U, Aydogan M, Cevik OM, Ofluoglu O. Anterior cervical fusion with interbody cage containing beta-tricalcium phosphate: clinical and radiological results. Acta Orthop Traumatol Turc. 2017; 51(3): 197-200. doi: 10.1016/j.aott.2017.03.001
3. Yu J, Ha Y, Shin JJ, Oh JK, Lee CK, Kim KN, et al. Influence of plate fixation on cervical height and alignment after one- or two-level anterior cervical discectomy and fusion. Br J Neurosurg. 2018; 32(2): 188-95. doi: 10.1080/02688697.2017.1394980
4. Chung JY, Park JB, Seo HY, Kim SK. Adjacent segment pathology after anterior cervical fusion. Asian Spine J. 2016; 10(3): 582-92. doi: 10.4184/asj.2016.10.3.582
5. Byval'tsev VA, Kalinin AA, Stepanov IA, Pestryakov YuYa, Shepelev VV. Analysis of the results of total cervical disc arthroplasty using a M6-C prosthesis: a multicenter study. Burdenko's Journal of Neurosurgery. 2017; 81(5): 46-55 (in Russian). doi: 10.17116/neiro201781546-55]
6. Roberts TT, Filler RJ, Savage JW, Benzel EC. Cervical total disk arthroplasty. Clin Spine Surg. 2018; 31(1): 6-13. doi: 10.1097/BSD.0000000000000607
7. Sasso WR, Smucker JD, Sasso MP, Sasso RC. Long-term clinical outcomes of cervical disc arthroplasty: a prospective, randomized, controlled trial. Spine. 2017; 42(4): 209-16. doi: 10.1097/BRS.0000000000001746
8. Gornet MF, Lanman TH, Burkus JK, Hodges SD, McConnell JR, Dryer RF, et al. Cervical disc arthroplasty with the Prestige LP disc versus anterior cervical discectomy and fusion, at 2 levels: results of a prospective, multicenter randomized controlled clinical trial at 24 months. J Neurosurg Spine. 2017; 26(6): 653-67. doi: 10.3171/2016.10.SPINE16264
9. Obernauer J, Landscheidt J, Hartmann S, Schubert GA, Thome C, Lumenta C. Cervical arthroplasty with ROTAIO® cervical disc prosthesis: first clinical and radiographic outcome analysis in a multicenter prospective trial. BMC Musculoskelet Disord. 2016; 17: 11. doi: 10.1186/s12891-016-0880-7
10. Berman D, Oren JH, Bendo J, Spivak J. The effect of smoking on spinal fusion. Int J Spine Surg. 2017; 11(4): 29. doi: 10.14444/4029
11. Hermann PC, Webler M, Bornemann R, Jansen TR, Rommelspa-cher Y, Sander K, et al. Influence of smoking on spinal fusion after spondylodesis surgery: a comparative clinical study. Tech-nol Health Care. 2016; 24(5): 737-44. doi: 10.3233/THC-161164
12. Vogt MT, Hanscom B, Lauerman WC, Kang JD. Influence of smoking on the health status of spinal patients: the National Spine Network database. Spine. 2002; 27(3): 313-9. doi: 10.1097/00007632-200202010-00022
13. Eubanks JD, Thorpe SW, Cheruvu VK, Braly BA, Kang JD. Does smoking influence fusion rates in posterior cervical arthrodesis with lateral mass instrumentation? Clin Orthop Relat Res. 2010; 469(3): 696-701. doi: 10.1007/s11999-010-1575-2
14. Pathria M, Sartoris DJ, Resnick D. Osteoarthritis of the facet joints: accuracy of oblique radiographic assessment. Radiology. 1987; 164(1): 227-30. doi: 10.1148/radiology.164.1.3588910
15. Cloward RB. The anterior surgical approach to the cervical spine: the Cloward Procedure: past, present, and future. The presidential guest lecture, Cervical Spine Research Society. Spine. 1988; 13(7): 823-7. doi: 10.1097/00007632-198807000-00020
16. Williams JR. The Declaration of Helsinki and public health. Bull World Health Organ. 2008; 86(8): 650-2. doi: 10.2471/BLT.08.050955
17. Sundseth J, Fredriksli OA, Kolstad F, Johnsen LG, Pripp AH, An-dresen H, et al. The Norwegian Cervical Arthroplasty Trial (NOR-CAT): 2-year clinical outcome after single-level cervical arthroplasty versus fusion - a prospective, single-blinded, randomized, controlled multicenter study. Eur Spine J. 2017; 26(4): 1225-35. doi: 10.1007/s00586-016-4922-5
18. Hu Y, Lv G, Ren S, Johansen D. Mid- to long-term outcomes of cervical disc arthroplasty versus anterior cervical discectomy and fusion for treatment of symptomatic cervical disc disease: a systematic review and meta-analysis of eight prospective randomized controlled trials. PLoS One. 2016; 11(2): e0149312. doi: 10.1371/journal.pone.0149312
19. Yin S,Yu X, Zhou S,Yin Z, Oiu Y. Is cervical disc arthroplasty superior to fusion for treatment of symptomatic cervical disc disease? A meta-analysis. Clin Orthop Relat Res. 2013; 471(6): 1904-19. doi: 10.1007/s11999-013-2830-0
20. Liu FY, Yang DL, Huang WZ, Huo LS, Ma L, Wang H, et al. Risk factors for dysphagia after anterior cervical spine surgery: a meta-analysis. Medicine (Baltimore). 2017; 96(10): e6267. doi: 10.1097/MD.0000000000006267
21. Nunley PD, Cavanaugh DA, Kerr EJ, Utter PA, Campbell PG, Frank KA, et al. Heterotopic ossification after cervical total disc replacement at 7 years-prevalence, progression, clinical implications, and risk factors. Int J Spine Surg. 2018; 12(3): 352-61. doi: 10.14444/5041
22. Tu TH, Kuo CH, Huang WC, Fay LY, Cheng H, Wu JC. Effects of smoking on cervical disc arthroplasty. J Neurosurg Spine. 2019; 30(2): 149-297. doi: 10.3171/2018.7.SPINE18634
Review
For citations:
Stepanov I.A., Byvaltsev V.А., Aliyev M.A., Aglakov B.M., Yussupov B.R., Pestryakov Yu.Ya., Shepelev V.V. The Impact of Smoking on Radiological Outcomes in Patients After Total Arthroplasty of the Cervical Intervertebral Discs. Journal of radiology and nuclear medicine. 2020;101(5):268-275. (In Russ.) https://doi.org/10.20862/0042-4676-2020-101-5-268-275