Poor nutrition
Osteoporosis
Previous back surgery
Multiple level spine fusion surgery
Severe deformities
Medications (e.g. non-steroidal anti-inflammatories, cortisone and chemotherapy)
Smoking
For patients with back pain and/or planning a spine fusion surgery, the best time to quit smoking is right away. There is no appropriate time start again. Smoking has no health benefits and an overwhelming number of health risks, including the risk of back pain and the risk of failed spine fusion surgery. At the very least, the patient needs to commit to not smoking for at least three months after the spine fusion surgery, as this is the most critical time for bone healing.