Effects of Ibuprofen and Smoking after a Cervical fusion

[shadowmom]

Why would a doctor say not to take any ibuprofen after a cervical fusion?  What does it inhibit and how?

Also, does anyone know of any smoker who has had a successful fusion?  How much of an impact does smoking have on fusions (percentage-wise)?  What if someone only smoked 2 cigs a day vs a pack?  One health care person will tell you that it ruins the chances of a fusion and another will tell you it only slows it down.     ???

I know of doctors that make you quit before they will operate but a friend of mine had a doctor that didn't make her quit first and months later she is still not fused.  Why is there so much confusion and not much consistency about smoking and how much is bad?

Thanks!

[JainMD]

Hi,
How are you feeling? What is your age? How many cigarettes you smoke per day?
Smoking reduces bone density and significantly impairs healing after surgery or trauma.
NSAID'S inhibit prostaglandins as it is there mechanism of action.
Prostaglandins are necessary for bone healing and bone growth.
But the use of NSAID's and they causing delay in bone healing is dependant upon dosage and duration for which NSAID's is used.
The conclusion, then and now, is that apart from ketorolac, and possibly indomethacin, there is not much evidence that NSAID’s or coxibs make any difference to bone healing after surgery or trauma, unless perhaps continued for months.
I would like to quote some statistics from a paper that would attempt to clear air about smoking and bone healing.
Interference in bone healing, especially union after spinal fusion surgery, has already been seen in one analysis, and has been explored further in another [*] that retrospectively identified 357 patients who underwent a posterior instrumented fusion at either L4-L5 or L4-S1. Clinical outcome and fusion status was analyzed in relation to preoperative and postoperative smoking parameters. The nonunion rate was 14% for nonsmokers and 27% for patients continuing to smoke after surgery. Patients who quit smoking after surgery for longer than six months had a nonunion rate of 17%. The nonunion rate was not significantly affected by either the quantity that a patient smoked before surgery or the duration of preoperative smoking abatement. Return-to-work was achieved in 71% of nonsmokers, 53% of non-quitters, and 75% of patients who quit smoking for more than 6 months after surgery.
Hope this helps.
Keep me informed.
Bye.
*-SD Glassman et al. The effect of cigarette smoking and smoking cessation on spinal fusion. Spine 2000 25: 2608-2615.

[kelli08]

I would like to know the same thing. I smoked until 8 days ago. I had surgery in October C6-C7 fusion. I also had one in April for C5 and smoked and it healed ok. My MD sd smoking would just slow the healing. My neurosurgeon doesnt know I smoke. I had quit but started back up he didnt ask and I didnt think to tell him. I go next week to see if starting to fuse and hopefully will be able to take off this C collar. I still have a lot of neck pain and my right arm still hurts. I would quit, why risk it. Wished i would have before surgery but didnt. There is a great website I found to help quit. Ive smoked for 29 yrs , 2 pks a day, if I can quit, anyone can.  www.quitsmokingonline.com
good luck