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Review Question - QID 7988

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QID 7988 (Type "7988" in App Search)
Smoking has been associated with lower fusion rates in both cervical and lumbar fusion. Which of the following statements best describes an explanation for these findings?

Nicotine impairs osteoblast activity, thus interfering with bone remodeling.

7%

17/247

The effects of smoking on bone healing are multifactorial and not yet fully understood.

49%

122/247

The vasoconstrictive and platelet-activating properties of nicotine inhibit fracture healing.

36%

89/247

Nicotine inhibits the function of fibroblasts, red blood cells, and macrophages.

4%

11/247

Hydrogen cyanide inhibits oxidative metabolism at the cellular level.

1%

3/247

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Tobacco smoking is now the leading avoidable cause of morbidity and mortality in the United States. The musculoskeletal effects of smoking have been implicated in osteoporosis, low back pain, degenerative disk disease, poor wound healing, and delayed fusion and fracture healing. A number of studies have demonstrated the relationship between smoking and development of pseudarthrosis. Numerous studies have been performed to offer an explanation of the mechanism mediating this effect. Whereas all of the above have been postulated as explanations, more recent studies have demonstrated that nicotine delivered via a transdermal patch significantly enhanced posterior spinal fusion in rabbits. Thus it appears that the effects of smoking on fracture healing are multifactorial and not yet fully understood.

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