ArticleSpinal cord2026
Influence of smoking status and cumulative smoking exposure on neurological recovery after surgery for degenerative cervical myelopathy: a prospective multicenter study.
Article in Spinal cord, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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16 authors.
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Abstract
STUDY
designProspective multicenter cohort study.
objectivesTo evaluate the association of smoking status and cumulative smoking exposure with postoperative neurological outcomes in patients undergoing surgery for degenerative cervical myelopathy (DCM).
settingMultiple institutions in Japan.
methodsA total of 935 patients with DCM were categorized as non-, past-, or current-smokers. Demographic characteristics, operative variables, and postoperative outcomes, including the Japanese Orthopaedic Association (JOA) score and recovery rate, JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), Short Form-36, visual analog scale, and Neuropathic Pain Symptom Inventory, were evaluated over a 2-year follow-up. Postoperative outcomes were analyzed across smoking categories using general linear models. Among current-smokers, cumulative smoking exposure was quantified using the Brinkman index and examined in relation to postoperative outcomes.
resultsDifferences in postoperative functional outcomes, including the JOA recovery rate and JOACMEQ upper and lower extremity functions, were observed across smoking categories. In contrast, neurological recovery, health-related quality-of-life measures, pain intensity, and overall neuropathic pain scores were generally comparable between the groups. Among current-smokers, cumulative smoking exposure did not demonstrate a clear association with neurological or functional outcomes; however, exploratory analyses identified differences in improvement in specific neuropathic sensory symptoms.
conclusionSmoking status was associated with differences in postoperative functional recovery after DCM surgery. In contrast, cumulative smoking exposure among current-smokers showed exploratory associations with specific neuropathic sensory outcomes but not with overall neurological or functional recovery. These findings suggest that smoking status and cumulative exposure may influence different outcome domains, supporting smoking cessation as part of preoperative patient management.
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