ArticleNorth American Spine Society journal2025
Non-tobacco nicotine dependence increases risk of complications following lumbar spine decompression and fusion.
Article in North American Spine Society journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Comparative Postoperative Outcomes After Rotator Cuff Repair in Tobacco and Nontobacco Nicotine Users.Orthopaedic journal of sports medicine · 2026Article
- Non-Tobacco Nicotine Is Associated With Increased Complications Following Posterior Cervical Fusion: A Retrospective Cohort Study.Global spine journal · 2026Article
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Authors and funding
11 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Non-tobacco nicotine products (eg, e-cigarettes, nicotine pouches) are increasingly used by cigarette smokers and prior nonsmokers. While the detrimental effects of cigarette dependence (CD) on healing and surgical recovery are well documented, the impact of non-tobacco nicotine dependence (NTND) on outcomes after lumbar spine surgery remains poorly characterized. Methods: We conducted a retrospective cohort study using the TriNetX database. Patients undergoing lumbar spine decompression and fusion were divided into 3 cohorts: NTND, CD, and controls (no documented nicotine dependence). Propensity score matching was performed 1:1 based on demographic and clinical characteristics. Complication rates were assessed at 90 days and 3 years postoperatively. Outcomes included anemia, deep vein thrombosis (DVT), myocardial infarction (MI), pneumonia, renal failure, pulmonary embolism (PE), sepsis, stroke, opioid abuse, pseudoarthrosis, and lumbar fracture. Results: A total of 39,195 matched NTND and control patients were analyzed. NTND was associated with increased 90-day risks of anemia, DVT, MI, pneumonia, renal failure, sepsis, stroke, and opioid abuse, as well as higher 3-year risks of pseudoarthrosis and lumbar fracture (p < .05). In a comparison of 36, 877 matched NTND and CD patients, NTND showed higher anemia risk but lower risks of MI, PE, renal failure, sepsis, stroke, and opioid abuse at 90 days. At 3 years, NTND carried a higher pseudoarthrosis risk but lower lumbar fracture risk relative to CD (p < .0001). When NTND and CD patients were combined ( Conclusions: NTND is associated with increased perioperative and long-term complications following lumbar spine surgery, including higher rates of infection, opioid abuse, pseudoarthrosis, and lumbar fracture. NTND demonstrates a distinct complication profile compared to CD, underscoring the need for further research on the impact of non-tobacco nicotine exposure on spinal fusion outcomes.
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