Nicotine Use Increases Risk of Complications After Cervical Disc Arthroplasty, confirms study

Key Findings

• Following 1:1 PSM, a total of 5,562 patients were included in the study. The adjusted analyses showed significant results:

• Nicotine users developed overall complications 37% more (adjusted odds ratio [aOR] = 1.37, 95% confidence interval [CI]: 1.13-1.66, p = 0.002).

• The risk of developing postoperative infections was 74% greater in nicotine users (aOR = 1.74, 95% CI: 1.17-2.58, p = 0.006).

• There was no notable difference in the risk of adverse discharge or length of stay longer than desired among non-users and nicotine users (p > 0.05).

• Male nicotine users had a 112% increased risk of infection (aOR = 2.12, 95% CI: 1.22-3.70, p = 0.008), while there was no such relationship among female patients.

• The risk of infection was especially higher in nicotine users with no diabetes, obesity, or chronic pulmonary disease (p < 0.05).

The study highlights the harmful effect of nicotine consumption on CDA surgical outcomes. The results indicate that nicotine exposure can weaken immune response and tissue repair, resulting in increased complications such as infections. Men seemed to be more susceptible to this risk than women, which might reflect underlying sex-specific physiological variations.

This study concludes that nicotine product use significantly increases the risk of complications, especially infections, in CDA patients. More research is required to investigate the underlying mechanisms and possible interventions to reduce these risks.

Reference:

Lin YJ, Shih FY, Huang JF, Ting CW, Tsai YC, Chang L, Wang HC, Chen WF. Impact of nicotine product use on outcomes of patients receiving cervical disc arthroplasty: a propensity score analysis of the united States nationwide inpatient sample 2005-2020. J Orthop Surg Res. 2025 Mar 19;20(1):298. doi: 10.1186/s13018-025-05700-8. PMID: 40108610; PMCID: PMC11924824.