Abstract
“Vaping” or the use of electronic cigarettes (e-cigarettes) has greatly increased within the past decade, with growing popularity among adolescents. E-cigarettes have many harmful effects on multiple organ systems, but more research is needed to fully understand the extent of possible risks. Our narrative literature review aims to provide comprehensive insight into the impact of e-cigarette use on spinal health with a specific focus on intervertebral disc (IVD) health, bone health, and spinal fusion. There are many metallic compounds and chemical flavoring additives within e-cigarette liquids that are associated with human toxicity. These chemical toxins have been linked to increased oxidative stress leading to systemic inflammation. E-cigarette carcinogens have shown to have a toxic effect on osteoblast cells, and long-term use may decrease bone mineral density and increase the future risk for osteoporosis. Additionally, nicotine in e-liquids negatively impacts IVD health by creating hypoxic environments that degenerate the IVD vasculature and cellular matrix. While studies have demonstrated the inhibitory effects of nicotine use on spinal fusions in animal models, the impact of e-cigarette use on spinal fusion operations in human patients is currently lacking. Future research should focus on the influence of e-cigarette use on spinal health, particularly in adolescents with long-term follow-up, as childhood is a critical time for bone growth and development. Additionally, studies exploring the effects of e-cigarettes on spinal surgery outcomes, such as spinal fusions, are sparse in the literature. Further prospective research studies with a focus on the variety of e-cigarette chemical toxins and flavoring agents is needed to assess the impact on spinal health.
Highlights
BackgroundElectronic cigarettes (e-cigarettes) were first designed by a Chinese pharmacist in 2003 [1]
Electronic nicotine delivery systems (ENDS) evolved from traditional disposable e-cigarettes, which are similar to conventional cigarettes in flavor and appearance, to large-size tank devices, and “pod-mod” devices such as JUUL® [2]
This study found that low doses of nicotine exposure may enhance spinal fusion, while high doses appear to be inhibitory [33]
Summary
Brian Fiani 1 , Christian Noblett 2 , Jacob M. University of Texas Medical Branch, Galveston, USA 7. There are many metallic compounds and chemical flavoring additives within e-cigarette liquids that are associated with human toxicity. These chemical toxins have been linked to increased oxidative stress leading to systemic inflammation. E-cigarette carcinogens have shown to have a toxic effect on osteoblast cells, and long-term use may decrease bone mineral density and increase the future risk for osteoporosis. Future research should focus on the influence of e-cigarette use on spinal health, in adolescents with long-term follow-up, as childhood is a critical time for bone growth and development. Further prospective research studies with a focus on the variety of e-cigarette chemical toxins and flavoring agents is needed to assess the impact on spinal health. Categories: Neurosurgery, Public Health, Epidemiology/Public Health Keywords: vaping, electronic cigarette, spine, smoking, electronic nicotine delivery systems, nicotine
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