Cigarette Smoke and Spine Surgery Recovery

Should You Avoid Second Hand Smoke?

Question: I am 27 years old and had a spinal fusion of L5-S1. I have been told that my bone did not fuse, and I will need to have surgery again. I grew up in a house with second-hand smoke and lived in the same situation after my surgery. Did the second-hand smoke contribute to my failed spinal fusion?
—Bowie, MD
female smoking while driving, blowing smoke at passenger Answer: This is an excellent question! Most people understand that smoking cigarettes will interfere with a healthy spinal fusion recovery, but second hand smoke can also impair your body's ability to heal after spine surgery.

Inhaling cigarette smoke (the key word being inhaling—which can happen even if you're a non-smoker) has a direct effect on how your bones heal. For a successful spinal fusion, your bones need an environment that promotes growth and fusion. Cigarette smoke prevents bones from growing properly, which is why it's so important that you not be around cigarette smoke if you've had a spinal fusion (or if you're going to have a spinal fusion soon).

Just like every other part of your body, your bones need nutrients to stay healthy. The nicotine in cigarette smoke prevents those nutrients from getting to your body because it slows down blood circulation. Slower blood circulation means that the oxygen moving through your body takes longer to deliver those vital nutrients.

You can read more about how cigarette smoke affects your bones in our article about smoking and spine surgery outcomes.

Spine surgeons have their own unique recommendations for their patients, but most will indicate that you shouldn't smoke or be around second hand smoke until your fusion is solid. And in the majority of cases, this rarely occurs until at least 6 months after your surgery.

If you need spine surgery, it's your responsibility and in your best interest to remove yourself from any environment that is detrimental to your healing—including a home filled with second hand smoke.

If you're living with someone who smokes, explain to them the effect second hand smoke may have on your recovery. You don't need to ask them to quit smoking, but you should feel justified in asking them to smoke outside. It may be the deciding factor in whether you require another spinal surgery.