THE EFFECT OF NICOTINE ON SPINAL-FUSION

被引:165
作者
SILCOX, DH [1 ]
DAFTARI, T [1 ]
BODEN, SD [1 ]
SCHIMANDLE, JH [1 ]
HUTTON, WC [1 ]
WHITESIDES, TE [1 ]
机构
[1] EMORY UNIV,SCH MED,DEPT ORTHOPAED SURG,SPINE SECT,ATLANTA,GA
关键词
LUMBAR SPINE FUSION; NICOTINE; NONUNION;
D O I
10.1097/00007632-199507150-00001
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. An animal model of posterior lateral intertransverse process fusion healing in the face of systemic nicotine. Objectives. To evaluate the effect of systemic nicotine on the success of spinal fusion and its effect on the biomechanic properties of a healing spinal fusion in an animal model. Summary of Background Data. Clinical observations suggested that cigarette smoking interferes with the healing of bony fusion. No direct link has been made to implicate nicotine as a cause for impaired healing of spinal fusions or fractures. Methods. Twenty-eight adult female New Zealand white rabbits underwent single level lumbar posterior lateral intertransverse process fusion using autologous iliac bone graft. Animals were randomly assigned to either receive systemic nicotine or receive no nicotine. Animals were killed 35 days after surgery. Manual testing of the fusion mass was performed to determine the fusion status. Each fusion mass underwent biomechanic testing. Results. Fifty-six percent of the control animals were judged to have solidly fused lumbar spines and there were no solid fusions in the nicotine group (P = 0.02). The mean relative fusion strength in the control group was greater (P = 0.09) than in the nicotine group. For the comparable stiffness figures, the control group was greater than the nicotine group (P = 0.08). Conclusions. This animal model established a direct relationship between the development of a nonunion in the presence of systemic nicotine. The results suggested that bone formed in the face of systemic nicotine may have inferior biomechanic properties.
引用
收藏
页码:1549 / 1553
页数:5
相关论文
共 20 条
  • [1] Benowitz N., Jacobs P., Daily intake of nicotine during smoking, Clin Pharmacol Ther, 4, pp. 499-504, (1984)
  • [2] Benowitz N., Clinical Pharmocology of Nicotine, Annu Rev Med, 37, pp. 21-31, (1986)
  • [3] Blumenthal S., Baker J., Dossett A., Selby D.K., The role of anterior lumbar fusion for internal disc disruption, Spine, 13, pp. 566-569, (1986)
  • [4] Boden S.D., Schimandle J.H., Hutton W.C., An experimental lumbar intertransverse process spine fusion model: Radio- graphic, histologic and biomechanical healing characteristics, Spine, 20, pp. 412-420, (1995)
  • [5] Brown C.W., Orme T.J., Richardson H.D., The rate of pseu- darthosis (Surgical nonunion) in patients who are smokers and patients who are nonsmokers: A comparison study, Spine, 8, pp. 942-943, (1983)
  • [6] Daftari T., Heller J.G., Whitesides T.E., Hutton W.C., The effect of nicotine on the revascularization of bone graft, Spine, 19, pp. 904-911, (1994)
  • [7] Devernejoul M.C., Herve M., Et al., Evidence for defective osteoblastic function. A role for alcohol and tobacco con-sumption in osteoporosis in middle-aged men, Clin Orthop, 179, pp. 107-115, (1983)
  • [8] Hanley E., Levy J., Surgical treatment of isthmic lumbosacral spondylolisthesis, analysis of variables influencing results, Spine, 14, pp. 48-50, (1989)
  • [9] Hollo I., Boross M., Gergely I., Smoking results in calcitonin resisitance, JAMA, 237, (1977)
  • [10] Hopper J.L., Seeman E., The bone density of female twins discordant for tobacco use, New Engl J Med, 330, (1994)