Perioperative GLP-1 receptor agonist use was associated with lower after long-segment spinal deformity surgery.
Evidence
A 1:1 propensity-matched retrospective cohort of adults undergoing posterior spinal deformity instrumentation across seven or more levels compared GLP-1 RA use within six months before or after surgery with no use.
Caveat
Because treatment assignment was observational and exposure could occur before or after surgery, residual confounding and timing ambiguity limit causal interpretation.
Simplified
Study DesignRetrospective Cohort StudyObjectiveThis study investigated the association between perioperative glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy and rates in patients undergoing long-segment spinal deformity surgery.MethodsAdult patients with a history of spinal deformity who underwent posterior segmental instrumentation spanning seven or more levels between 7/1/2010 and 7/1/2024 were identified. Patients prescribed a GLP-1 RA within six months before or after surgery comprised the experimental group; patients without GLP-1 RA use comprised the control group. Cohorts were balanced 1:1 by demographic characteristics and medical comorbidities. The primary outcome was the clinical diagnosis of pseudoarthrosis at 6 months, 1 year, 2 years, and 3 years following the index procedure; relevant 90-day medical complications were also assessed using risk ratios (RR) and 95% confidence intervals.ResultsPerioperative GLP-1 RA use was associated with a significant reduction in risk of pseudoarthrosis at 6 months (RR 0.677,), one year (RR 0.708,), two years (RR = 0.671,), and three years (RR = 0.714,) following the index procedure. Perioperative GLP-1 RA use was also associated with a significant reduction in hospital readmission (RR 0.863,) and sepsis (RR 0.485,) within 90 days following the index procedure.ConclusionsThis study supports the potential protective effect of GLP-1 RAs against the risk of pseudoarthrosis in patients who underwent long-segment spine deformity surgery. Further, perioperative GLP-1 RA therapy was not associated with increased risk of medical complications in the 90-day postoperative period and may reduce hospital readmission and sepsis. P = .028P = .036P = 0.010P = .024P = .012P = .002
Key numbers
0.677
Decrease in Risk at 6 Months
Risk ratio for at 6 months in GLP-1 RA users vs. non-users.
0.485
Decrease in Sepsis Risk
Risk ratio for sepsis within 90 days in GLP-1 RA users vs. non-users.
Full Text
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GLP-1 Therapies