The impact of semaglutide use for weight loss on transforaminal lumbar interbody fusion outcomes

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-05-15 DOI:10.1016/j.clineuro.2025.108952

Syed I. Khalid , Pranav Mirpuri , Elie Massaad , Ryan Wang , Aladine Elsamadicy , John H. Shin , Owoicho Adogwa

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引用次数: 0

Abstract

Introduction

While glucagon-like peptides 1 receptor agonists (GLP-1RAs) grow in popularity, their potential for presurgical weight optimization in spine surgery remains unclear. We examined the influence of semaglutide prescription on one- to three-level transforaminal lumbar interbody fusion (TLIF) outcomes.

Methods

Retrospective analysis of obese, non-diabetic patients was conducted from 2018 to 2022. A 1:1 exact match paired semaglutide users with non-users based on age, gender, surgical levels, and comorbidities. The primary outcome were the rates of surgical and medical complications at 30 days following TLIF. A sub analysis assessed outcomes after stratifying by prescription duration (greater or less than nine months). Kaplan-Meier survival analyses evaluated the need for additional lumbar fusion. The alpha was set to 0.05, but with the Bonferroni correction the significance threshold was set to 0.0045.

Results

471 semaglutide users were matched with 471 non-users with no baseline differences. Semaglutide users had higher rates of pneumonia (2.97 % vs 0.85 %, p < 0.05) compared to nonusers. When stratified by prescription duration, patients with longer semaglutide use had a higher incidence of urinary tract infection (4.03 % vs 1.27 %, p < 0.05) and acute kidney injury (3.18 % vs 0.85 %, p < 0.05). The need for additional lumbar fusion was associated with both semaglutide use (17.0 % vs. 6.4 %, p < 0.0001) and duration (28.3 % vs. 4.8 %, p < 0.0001).

Conclusions

Semaglutide may adversely affect lumbar fusion outcomes and necessitate additional surgery, possibly secondary to its systemic effects on bone metabolism and weight loss patterns. Further research into optimal drug formulation, dosage, and weight loss protocols will be required before mainstream use.

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西马鲁肽用于减肥对经椎间孔腰椎体间融合结果的影响

虽然胰高血糖素样肽1受体激动剂（GLP-1RAs）越来越受欢迎，但其在脊柱外科术前体重优化方面的潜力仍不清楚。我们研究了西马鲁肽处方对一至三节段经椎间孔腰椎椎体间融合（tliff）结果的影响。方法回顾性分析2018 - 2022年肥胖、非糖尿病患者。根据年龄、性别、手术水平和合并症，对使用西马鲁肽的患者和未使用西马鲁肽的患者进行1:1的精确配对。主要观察指标是TLIF术后30天的外科和内科并发症发生率。亚组分析评估了按处方持续时间（大于或小于9个月）分层后的结果。Kaplan-Meier生存分析评估了额外腰椎融合的必要性。alpha被设置为0.05，但通过Bonferroni校正，显著性阈值被设置为0.0045。结果471名semaglutide使用者与471名非使用者配对，无基线差异。Semaglutide使用者与非使用者相比，肺炎的发生率更高（2.97 % vs 0.85 %,p <； 0.05）。按处方时间分层时，使用西马鲁肽时间较长的患者尿路感染（4.03 % vs 1.27 %,p <； 0.05）和急性肾损伤（3.18 % vs 0.85 %,p <； 0.05）的发生率较高。额外腰椎融合的需要与使用西马鲁肽（17.0 % vs. 6.4 %,p <； 0.0001）和持续时间（28.3 % vs. 4.8 %,p <； 0.0001）有关。结论：semaglutide可能会对腰椎融合结果产生不利影响，需要额外的手术，可能是继发于其对骨代谢和体重减轻模式的全身影响。在主流使用之前，需要进一步研究最佳药物配方、剂量和减肥方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.