Question
That is going to be a pretty tall order : )  
I jsut found out that nicotine is bad for fusion (known all along that it is not healthy and hard to stop).  My surgery is Friday.  I am going to try to quit cold turkey... yikes.  Hopefully, a couple of slip ups wont destroy the whole fusion process.  What do you think?
Thanks again,
Mike
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The text above is a follow-up to ...

-----Question-----
I am having a TLIF minimally invasive fusion s1-l5 on friday.  I was reading some on the questions and answers regarding smoking and bone fusion.  I am a tobacco chewer.  Do you think this will effect the fusion?  Is it smoking only or is it nicotine?  How much of an effect does it have?  I am worried about having to quit chewing AND deal with back surgery recovery...
-----Answer-----
Hi Mike,
Thanks so much for your questions.

The problem is not the tar that builds up after smoking but the nicotine in tobacco. The nicotine hinders the healing proccess which can take several months.

If the fusion does not heal properly, then a second fusion will probably be necessary. And because one fusion has been attempted, there's no guarantee the second will be successful. Nicotine is the #1 cause of fusions failing. When you add in a previous fusion surgery, the chances of ever having a successful fusion is greatly diminished.

The best advice I can give you is to quit using tobacco products. Besides the obvious health risks (oral cancer), you don't want to go through surgery more than once.

If you have any more questions, please feel free to ask me anytime.

Thanks again,
John McKinzie

Answer
Hi Mike,

I would suggest you really try hard. You want as little nicotine in your body as possible to give the fusion it's best chance of healing.

Remember, if the fusion doesn't heal properly, another one may be needed AND then that adds to the possibility of a future fusion failing to properly heal.

Please understand that I'm not trying to lecture you but this is very important. Even though this is going to be a minimally invasive procedure, you've got to give yourself the best opportunity for your body to heal. If you are doing something that could prevent that, you could be faced with some very serious complications and consequences.

I sincerely hope you are able to quit and that you have a successful surgery. Sometimes we don't realize what we can do until we are presented with a challenged.

Don't hesitate to ask me again if you have any more questions. I would like to know how everything turns out for you.

Take care,
John McKinzie