The Use of Semaglutide in Patients Undergoing Lumbar Fusion Does not Increase 90-Day Medical or 1-Year Implant Complications.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY Clinical Spine Surgery Pub Date : 2025-03-17 DOI:10.1097/BSD.0000000000001800

Abdullah Ghali, Jad Lawand, Parker Mitchell, David Momtaz, Umar Ghilzai, Eileen Phan, Jude Alawa, Lorenzo Deveza

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Abstract

Study design: Retrospective Cohort Study of National Database.

Objective: This study examines their effect on medical and mechanical complications within 90 days postlumbar spine surgery.

Summary of background data: Patients undergoing spinal procedures increasingly use glucagon-like peptide-1 receptor agonists (GLP-1 RAs), originally for type 2 diabetes and now popular for weight loss. The impact of GLP-1 RAs on spinal fusion outcomes is unknown.

Methods: This study used medical records from TriNetX, a national deidentified database, to examine diabetic patients undergoing lumbar spine procedures. Patients receiving GLP-1 RAs within 6 months preoperatively were compared with a propensity-matched control group. Propensity score matching (1:1) controlled for demographic factors and comorbidities, including type I and II diabetes, metformin use, and BMI. The study analyzed 90-day medical and 1-year implant complications using χ2 exact tests and univariate regression in a propensity-matched cohort.

Results: The GLP-1 RA cohort and control group included 1110 and 151,440 patients, respectively. Of these, 1090 patients were propensity-matched 1:1 in each cohort. Within 90 days postoperatively, the GLP-1 RA group had higher rates of all-cause anemia (9.4% vs. 7.0%, P=0.016), renal failure (4.4% vs. 2.9%, P=0.028), opioid use (94% vs. 89%, P<0.001), emergency room visits (16% vs. 13%, P=0.013), and wound complications (0.5% vs. 0.2%, P<0.001). Other complications, such as infections, myocardial infarction, pulmonary embolism, deep vein thrombosis, hypoglycemic events, stroke, hospitalization, pneumonia, and transfusion, were similar between groups. One year postoperatively, pseudoarthrosis was less frequent in the GLP-1 RA group (12% vs. 16%, P=0.002). There were no significant differences in hospitalization, adjacent segment disease, mechanical loosening, or postlaminectomy syndrome.

Conclusion: This study found that the risk of complications in patients receiving GLP-1 RAs before lumbar spine surgery is comparable to control patients, suggesting GLP-1 RAs do not increase adverse outcomes and should not exclude patients from surgery.

Level of evidence: Level III-therapeutic study.

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.