General Spine

Negative effects of smoking, workers’ compensation, and litigation on pain/disability scores for spine patients.

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Purpose of Study
Study Review

This study is a retrospective review of two institutions that collected patient information from 2000 to 2008.  13,704 consecutive patients  with spinal disorder complaints answered questions regarding smoking status,  ODI, VAS and litigation or workers compensation status.

No other information was collected.  There is no followup to these patients.


The overall demographic data breaks down in the following manner:

24% were current smokers.

46% were non smokers.

5.7% were involved in a workers compensation

6.1% were involved in  litigation

Smoking is associated with increased self reported disability  (ODI).

Workers compensation or litigation status had statistically increased levels of self reported pain (VAS) and disability (ODI).

The authors commented that this is a population based review, and not specific to any 1 person.

At the same time, this information is consistent with known prior studies, and clinical experiences of most experienced orthopedic surgeons.

The authors cautioned Clinicians on expectations for clinical outcomes.  Smoking, and ongoing litigation has potential to effect efficacy of clinical treatments.

Data was collected from two university spine centers.  The group may not be representative of the general population.

There may be under reporting of the number of patients who are in litigation, or under a Worker’s Compensation situation.

However, based on this self reporting of VAS and ODI, the authors demonstrates higher pain scores in smokers, and higher pain and disability scores for people in a Worker’s Compensation or litigation setting.

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