You have the option of undergoing a kyphoplasty procedure to resolve your spinal compression fracture, which should relieve your chronic back pain. However, the surgeon has told you that you must quit smoking several weeks before the surgery. You know quitting smoking will be difficult, and you'd just as soon not stop. Is it typical for surgeons to set this requirement? Should you try to find a different surgeon?

Orthopedic surgeons and other specialists who perform back surgery generally do either require or at least strongly encourage patients to stop smoking before the operation. Several effects of smoking may convince you to go along with the advice.

Reasons Smoking Is Problematic for Spinal Surgery

Compromised Circulation

People who smoke are more prone to developing low back pain than those who don't, according to the American Academy of Orthopedic Surgeons, or AAOS. It's unclear why this happens, but it may be because nicotine narrows blood vessels, thus restricting circulation. That could leave you at greater risk for chronic back pain even if you have the kyphoplasty procedure. 

Good circulation is vital for healing after surgery. Adequate blood flow brings a plentiful supply of oxygen and nutrients to the spinal column and to the incision site. It also transports toxins and waste matter to the kidneys and liver for filtering and subsequent elimination from the body. 

Greater Risk of Infection

Smokers are more likely to develop an infection at the incision site, as verified by a study published in 2003. This may occur because of inadequate oxygen supply to the area through circulation. Wound infections can become serious and difficult to treat. 

The research found that 12 percent of surgical patients who were smokers developed wound infections compared with only 2 percent of people who had never smoked. However, participants who had quit smoking four weeks prior to the surgery had fewer infections than those who continued smoking. 

Slower Production of Bone

Smoking increases the risk of osteoporosis, or decreased bone strength and density, for various reasons detailed by the AAOS. It reduces your absorption of calcium, which is essential for the creation of bone cells. In addition, when you smoke, the body slows its production of osteoblasts, which are cells that make bone. The decrease in blood circulation also contributes to osteoporosis. 

All these factors increase the risk that the kyphoplasty procedure will fail or that you will suffer another bone fracture in the future.

Higher Risk of Pulmonary and Cardiovascular Complications

Even without undergoing surgery, smoking increases the risk of certain serious health problems. Individuals who smoke are at greater risk of pneumonia, heart attack and stroke because of smoking's detrimental effects on the lungs, heart and blood vessels. 

Surgeons prefer that their patients do not have this extra risk factor for serious complications. 

Can You Eventually Start Smoking Again?

If you really enjoy smoking, you may hope that you can start once again after your operation. Of course, doctors recommend that you never return to this habit -- not only for the health of your back, but for your entire body. Consider that smoking is the direct cause of one in five deaths annually in the United States, according to the Centers for Disease Control. In fact, it's the primary cause of preventable deaths in this country. 

Your best course of action is to talk with your primary care doctor about effective methods for quitting altogether. In the 2003 study, smokers who were abstaining and wore a nicotine patch in the meantime had the same results as non-smokers and those who wore a placebo patch. Unfortunately, although this seems to work for wound healing, wearing a nicotine patch may be inadvisable before spinal surgery because of nicotine's effects on bones and other parts of the body. Consult your surgeon about this before proceeding.