Abdullah Ghali, Jad Lawand, Parker Mitchell, David Momtaz, Umar Ghilzai, Eileen Phan, Jude Alawa, Lorenzo Deveza
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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 χ 2 exact tests and univariate regression in a propensity-matched cohort.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Level of evidence: </strong>Level III-therapeutic study.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Use of Semaglutide in Patients Undergoing Lumbar Fusion Does not Increase 90-Day Medical or 1-Year Implant Complications.\",\"authors\":\"Abdullah Ghali, Jad Lawand, Parker Mitchell, David Momtaz, Umar Ghilzai, Eileen Phan, Jude Alawa, Lorenzo Deveza\",\"doi\":\"10.1097/BSD.0000000000001800\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Retrospective Cohort Study of National Database.</p><p><strong>Objective: </strong>This study examines their effect on medical and mechanical complications within 90 days postlumbar spine surgery.</p><p><strong>Summary of background data: </strong>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.</p><p><strong>Methods: </strong>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 χ 2 exact tests and univariate regression in a propensity-matched cohort.</p><p><strong>Results: </strong>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). 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引用次数: 0
摘要
研究设计：国家数据库回顾性队列研究。目的：本研究探讨其对腰椎手术后90天内医学和机械并发症的影响。背景资料总结：接受脊柱手术的患者越来越多地使用胰高血糖素样肽-1受体激动剂（GLP-1 RAs），最初用于2型糖尿病，现在流行用于减肥。GLP-1 RAs对脊柱融合结果的影响尚不清楚。方法：本研究使用来自TriNetX（一个国家数据库）的医疗记录，对接受腰椎手术的糖尿病患者进行检查。术前6个月内接受GLP-1 RAs治疗的患者与倾向匹配的对照组进行比较。倾向评分匹配（1:1）控制了人口统计学因素和合并症，包括I型和II型糖尿病、二甲双胍使用和BMI。在倾向匹配队列中，采用χ2精确检验和单变量回归分析了90天的医疗并发症和1年的植入并发症。结果：GLP-1 RA队列和对照组分别包括1110例和151440例患者。其中，1090名患者在每个队列中呈1:1的倾向匹配。术后90天内，GLP-1 RA组全因贫血（9.4% vs. 7.0%， P=0.016）、肾功能衰竭（4.4% vs. 2.9%， P=0.028）、阿片类药物使用（94% vs. 89%）发生率较高。结论：本研究发现，腰椎手术前接受GLP-1 RAs治疗的患者并发症风险与对照组相当，提示GLP-1 RAs治疗不会增加不良结局，不应将患者排除在手术外。证据等级：iii级——治疗性研究。
The Use of Semaglutide in Patients Undergoing Lumbar Fusion Does not Increase 90-Day Medical or 1-Year Implant Complications.
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 χ 2 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.
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.
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