Impact of Cigarette Smoking on Clinical Outcomes after Surgical Resection in Patients with Intramedullary Spinal Cord Tumors: A Retrospective Comparative Study.

Introduction: Intramedullary spinal cord tumors (IMSCTs) are rare lesions associated with significant neurological impairment and decreased quality of life. Surgical resection is the primary treatment option; however, postoperative recovery is often limited and functional outcomes vary considerably. Although cigarette smoking is known to adversely affect outcomes in various spinal disorders, its impact on IMSCT surgery remains unclear. This study aimed to determine the influence of cigarette smoking on surgical outcomes and perioperative complications in patients with IMSCTs. Methods: This retrospective comparative study included 194 consecutive patients with IMSCTs who underwent surgical resection between 2012 and 2022. Participants were categorized into smoker (n=35) and nonsmoker (n=159) groups based on smoking status. Demographic, surgical, and clinical outcomes were compared between the two groups. Results: The smoker group had significantly lower pre- and postoperative Japanese Orthopaedic Association (JOA) scores for cervical and thoracic lesions than the nonsmoker group, with no significant improvement observed at the final follow-up. However, there were no significant differences between the groups in other demographic data, surgical data, perioperative complications, or postoperative modified McCormick scale grade changes for either cervical or thoracic IMSCTs. In addition, preoperative smoking status (the number of cigarettes smoked/day, years of smoking, total number of smoked cigarettes) showed no significant correlation with pre- or postoperative JOA scores. Conclusions: Although smoking does not affect the incidence of perioperative complications, it negatively impacts JOA scores in patients with IMSCTs, regardless of the number of cigarettes smoked or the duration of smoking.