When somebody is experiencing back pain severe enough that they are contemplating surgical options to relieve it, their medical providers not only want to determine the best treatment plan but also the optimal conditions to promote their recovery afterward. For some patients, it can turn out that a significant factor contributing to their back pain—smoking—could present a serious obstacle to a successful outcome of spinal fusion surgery.
According to the Centers for Disease Control, in 2022 an estimated 28.8 million U.S. adults smoked cigarettes (approximately 11.6% of the adult population), defined as “smoking ≥100 cigarettes during a lifetime and now smoking cigarettes either every day or some days.” The good news is that this represents a significant decrease, thanks to the effects of public health campaigns and growing awareness of smoking’s negative health impacts (for contrast, in 1980 32.8% of adult men and 32.7% of adult women smoked). The bad news is that smoking affects far more than the lungs. The link between smoking, chronic back pain, accelerated spinal degeneration, and poorer outcomes after spinal fusion must be fully considered to ensure that smokers are fully informed as to their risks and to illuminate the benefits of quitting smoking for spinal health.
Tobacco smoke contains thousands of chemicals, including 70 known carcinogens, as well as nicotine. The effects these substances have on the development of back issues include:
| Effect of Smoking | Why It Happens | What It Does to the Back |
| Reduced blood flow and nutrient delivery | Chemicals in tobacco smoke, including nicotine, are vasoconstrictors (substances that cause blood vessels to narrow). The supply of oxygen and essential nutrients to the spinal discs and vertebrae is lowered. | A reduced blood supply interferes with spinal health, making it harder to repair damage. Degeneration accelerates, making chronic pain and other conditions more likely. |
| Increased inflammation | Chronic inflammation, caused by nicotine and other toxins in cigarette smoke, increases pain and stiffness in the spine, exacerbating conditions like sciatica and arthritis. | For patients who already have back pain, symptoms are more difficult to manage and more constant if they also smoke. |
| Accelerated disc degeneration | Toxic chemicals in tobacco smoke break down collagen in the intervertebral discs that act as the spine’s shock absorbers, weakening them. | Lack of healthy disc structure leads to early-onset back pain and spinal deterioration; studies show that smokers are more prone to spinal stenosis, degenerative disc disease, and herniated discs. |
The same factors that make smoking bad for back health in general make it a serious concern for anybody contemplating a spinal fusion surgery. For a fusion to be successful, the bones must fuse properly, but smoking reduces the activity of bone-forming cells (osteoblasts), resulting in weaker bone formation. In addition, constricted blood vessels due to nicotine reduces oxygen supply to the surgical site, prolonging healing and increasing the risk of infection. Smokers are more likely to experienced failed spinal fusions, surgical complications, longer hospital stays, and increased pain than nonsmokers.
These are not foregone conclusions for someone who currently smokes but is considering back surgery. Studies show that quitting smoking prior to surgery significantly improves success rates, reducing complications, promoting faster recovery, and increasing the likelihood of achieving solid bone fusion.
On top of improving surgical outcomes, eliminating smoking has a positive effect on overall spine health. Among the benefits are the restoration of proper blood circulation, which increases the oxygen and nutrients the spine needs for healing. The body’s inflammatory response also decreases, which can diminish the amount of pain a patient experiences even without further intervention.
Of course, smoking is a notoriously hard habit to quit, so anybody who is contemplating quitting should consult their doctors for support. Medical professionals can provide guidance and resources to help patients quit smoking, including counseling, support groups, nicotine replacement therapies (NRTs), and prescription medications. As quitting smoking also reduces the risk of lung conditions, heart disease, and stroke, the reward for making this change is likely to have impacts far beyond alleviating back pain.
If you’re suffering with back pain, you just want it to stop, but the success of potential treatments is closely tied to your overall health. Dr. Tiffany Rogers, a board-certified orthopedic surgeon specializing in spine care, takes a holistic approach to finding the least invasive effective means to treat spinal issues, including non-operative approaches such as physical therapy, medication, spinal injections, and more. If surgery is necessary, artificial disc replacement can be an alternative for spinal fusion. To find out more about your options for treating your back pain, contact us here today.
Mike was barely able to walk. I did his surgery and now he’s traveling the world with his wife! That pic is from Africa, hiked up to see mountain gorillas…
I feel very blessed to have walked in to the office for a consultation with Dr Rogers. On that day upon review of my MRI report she determined that I needed emergency surgery due to extremely compressed spinal cord at C3/4. Now I knew it was compressed for some time but I avoided going to the surgeon because I was afraid to have surgery. She calmly explained the alternatives to not having the surgery and it was a no brainer. My symptoms had gotten really bad and I knew she was right. I trusted her judgement and I am so happy that I had the surgery. Almost immediately my symptoms improved!! All of the nurses and other doctors at Torrance Memorial praised her work also and she was very well respected. I would recommend Dr Rogers because not only was my surgery a success but she also showed great compassion for me because I was very sad to be in the hospital during the Holidays. To me this shows she cares about healing the whole person.
I have Dr Rogers to thank for the rest of my life. At 12 I was told by a specialist that I was born with a deformity in my spine which was causing slight scoliosis. At 20, I started experiencing back pain, constantly feeling the need to crack my back for some relief, tossing and turning all hours of the night, seeking massages. As I started to get older, the pain only increased. By 23, my back began to “lock” on me. I would bend over or lean forward and my nerves would pitch, causing me to not be able to move for a few seconds. At first I had kaiser insurance, the “spinal specialist” if you can even call her that said there was no possible surgery to fix my spine and back pain. She told me PT and epidural spinal injections were the answer….. (wrong, very wrong!) I got this run around with kaiser for 2 years!!!!
By 25, I was BEYOND frustrated and in pain, so my (now) husband put me on his insurance, and I was able to find Dr Rogers. She requested an MRI and X-rays, and saw what was wrong with my spine and what needed to be done. I needed a spinal fusion and decompression. She even referred me to a spinal specialist in LA, to get a second recommendation, and he agreed with everything she wanted to do for my surgery. I had full trust in Dr Rogers. She was always kind, always informative, and reassured me I was going to be alright. As a fellow athlete, she understood what I was sacrificing for this surgery. My love for playing soccer would have to come to an end post surgery due to the risk of blowing out another level of my spine. She was compassionate and again gave me reassurance I would eventually be pain free and be able to carry my own children which was the most important to me.
I underwent my lumbar spinal surgery with a spinal fusion and decompression August 2016. The pain and recovery I experienced post surgery was the most pain I’ve ever felt. Pain meds helped, but you really have to be dedicated to taking the vitamins Dr Roger recommends, and doing the amazing PT she prescribed. The PT was Pilates based, and it seriously did my recovery wonders.
By March 2017, I was ready to move to another state and went in for one last check up with Dr Rogers. She did another X-ray, and told me that my fusion looked so good and healthy , that I could start playing soccer again. Not competitively, but recreationally, and now I am nearly 2 years post spinal surgery, playing on 2 soccer teams, active in the gym, and my husband and I are trying to start a family.
I still experience soreness in my lower spine if I lift too heavy of objects the wrong way or work out too hard, but that is to be expected. I have been off any type of medication spine related for over a year now, and it’s nothing a little ice won’t cure. All in all I have a lot to thank Dr Rogers for. She saved my back.
Thank you so much Dr Rogers!!!!
Dr Rogers has been taking care of my back issues for years. It came to a point that I did need a major surgery. A fusion. I am so glad it was done. Just wished I’d done it earlier. My leg pain is gone, the back spasms are gone , feeling like my ribs were stabbing me is also gone and though I’m still healing I feel so much better. I am so grateful to Dr Rogers !! I would highly recommend her for spine issues. Forever thankful!! The staff is professional and friendly also.
Update!!
It’s been a year and a half since my back surgery with Dr Rogers and I’m doing great!! Thank you again Dr Rogers!!
There are two major factors in my thinking a doctors office is 5 stars… #1 is the office and staff itself… #2 is the moment you meet the doctor and how they present themselves to you. Being someone that’s had multiple surgeries, dealt with dozens of doctors and facilities… if these two are in line when you go on your first visit, you know the experience and the healing to come will be worth it.
I have to say, the offices, ease of getting there, parking… were amazing… the staff at the front desk (and on the phone for that matter) were some of the most engaging, informative and easy to deal with that I’ve ever encountered. They made it EASY for me to check in, etc… I was taken in at the exact time of my appointment (I did listen and get there 15 minutes early) and was escorted through, had X-rays and waited for Dr. Rogers…
The moment I met Dr. Rogers, I had faith that I was in the right hands. Her eye contact, the way she shook my hand, the way she listened… the deep understanding she immediately had for my symptoms and the journey I’ve been on for the last 10 years after of my spine surgery in New York… made me incredibly calm and gave me such peace.
I see her again next week, after a battery of tests… but I look forward to finding answers with this healing doctor and her colleagues and staff…
xoxox
I am writing this review on behalf of Dr. Rogers patient, Yolanda Phelps.
Dr.Rogers performed an anterior cervical disectomy and cervical fusion on me last Tuesday. I am home now and my recovery is going great. Dr. Tiffany Rogers was so caring, thorough, and made me feel so comfortable during this difficult procedure. She took very good care of me and I am so thankful for her help.
Also her PA Jeff was so kind and helpful as well. Thank you so much you two for everything!!
PS don’t waste time going through pain go to dr. Tiffany Rogers. She does all the bells and whistles!!
Dr. Rogers is Exceptional. I am a patient of hers. I was in extreme pain Christmas week. Doctor Rogers ordered an MRI. Diagnosis was dislocated shoulder. I called her office 12/27/18. Doctor called back. She asked if I could be in her office immediately. I saw her within 1/2 hour. She injected me with Cortisone.What a God given gift!
Dr. Rogers is obsessed with the ability to heal. She went above and beyond to releive my pain.
Thank you Dr. Rogers.
