Impact of perioperative GLP-1 agonist use on pseudarthrosis rates following single-level anterior cervical discectomy and fusion: a propensity-matched cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Anterior cervical discectomy and fusion (ACDF) is a widely performed surgical procedure for treating cervical spine pathologies, with pseudarthrosis remaining a significant postoperative challenge. While glucagon-like peptide-1 (GLP-1) receptor agonists have demonstrated beneficial effects on vascular health and bone metabolism, their impact on cervical fusion outcomes remains unexplored. This study investigates the relationship between perioperative GLP-1 agonist use and pseudarthrosis rates following single-level ACDF procedures. Methods: We conducted a retrospective propensity-matched cohort study using the TriNetX database. retrospective analysis using the TriNetX Research Network database, examining records from October 2010 to October 2022. The study population included patients who underwent single-level ACDF procedures. One-to-one propensity score matching (PSM) was performed to account for demographic factors, body mass index (BMI), hemoglobin A1c (HbA1c), and relevant comorbidities. Pseudarthrosis rates were evaluated at 6 months, 1 year, and 2 years postoperatively. Results: Of 28,133 patients who underwent ACDF, 555 were prescribed GLP-1 agonists within 6 months of surgery. After PSM, 546 patients were included in each cohort. The GLP-1 agonist cohort demonstrated significantly lower odds of developing pseudarthrosis at 6 months [odds ratio (OR): 0.60, 95% confidence interval (CI): 0.42-0.87], 1 year (OR: 0.65, 95% CI: 0.46-0.94), and 2 years (OR: 0.62, 95% CI: 0.44-0.86) postoperatively compared to the non-GLP-1 agonist cohort. Conclusions: GLP-1 agonist use was associated with significantly reduced pseudarthrosis rates following ACDF procedures across all measured time points. These findings suggest potential benefits of GLP-1 agonists in cervical fusion outcomes, independent of their metabolic effects. Further prospective studies are warranted to validate these results and elucidate the underlying biological mechanisms.
Source: Journal of Spine Surgery
DOI: 10.21037/jss-25-142
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7128372992