Independent and combined associations of cannabis and nicotine use with postoperative outcomes after cervical and lumbar interbody fusion: a retrospective cohort study

Abstract Background Context: Cannabis use has increased substantially in the United States and is commonly perceived to improve pain control and reduce opioid requirements. However, its perioperative impact in spine surgery remains unclear, particularly when isolated from nicotine use. Purpose: To evaluate the independent and combined associations of cannabis and nicotine use with postoperative outcomes following cervical and lumbar interbody fusion. Study Design/Setting: Retrospective cohort study using the TriNetX Research Network, a federated national database of deidentified electronic health records