I'm glad your surgeon gave you the answer you were seeking. However, the best possible solution would have been to have stopped smoking months prior to the date for surgery so you didn't even have to worry over whether it was the nicotine or the smoke, or the process of smoking that was the culprit.

I can find any number of studies on the effect of nicotine on spinal fusion. To a study, the conclusion is that there is a direct relationship between the development of a nonunion in the presence of systemic nicotine. The results also indicated that bone formed in the face of "systemic nicotine" may have "inferior biomechanic properties".

There are, of course,also many studies showing that the chemicals that are released when a cigarette is smoked lower the oxygen levels, increase some of the other levels, etc. and make it much more difficult for the body to make good bone...and this factor is responsible for the high rate of non-union among smokers.

This really is not an either/or argument. Instead of quibbling over the various clinical studies, it is far easier for surgeons to simply say that smoking has been shown to dramatically lessen the chances for a strong fusion.

There are other reasons for non-fusion besides smoking...Sometimes there does not appear to be any reason why a patient does not fuse. But there is clinical evidence showing that people who smoke have a much higher rate of non-fusion than non-smokers, so it is an easy thing to tell patients to cut out. Incidentally, I found one study that included tobacco chewers in with the tobacco smokers....

You might be interested in reading the following from the state of Washington:

http://www.lni.wa.gov/ClaimsIns/Providers/Treatment/Presc/Policy/SpecCov...

They want people to stop using tobacco products 90 days prior to fusion surgery and for 180 days after surgery. But it is OK to use "tobacco use cessation products" so they must not contain enough tobacco to make a difference.

We all should take our doctors' advice over anything we see online. We should find a different doctor if we trust his advice less than what we read online.

Good luck with your upcoming surgery. I will be interested to follow your reports about your fusion procedure.

I to am trying to quit smoking due to surgery on Feb 8th.Having fusion from L4 down with extra's. Tried the patches and lozenge and didn't do too well. Now have Zyban and think this is going to work for me. I understand from my surgeon that the reason for needing to be "smoke-free" is during the actual sugery and then afterwards with the need for the bones to fuse and nictotine won't help but hinder this process.I'm not an expert but I know it's hard to quit smoking and will try to find any info. to give me an excuse not to quit. I have found none!!!!
If I can help you quit or be any support, please fee free to contact me. Good Luck, Hugs n' Loves - Paula

Thanks for the links, I have read them before. Why I asked my doctor. I have quit smoking and thats a start. I will definatley let you know how it turns out.