Preoperative Semaglutide Use in Patients Undergoing Single-Level Lumbar Fusion Results in Lower Infection and Pseudoarthrosis Rates: A Propensity-Matched Retrospective Cohort Analysis
Medical Student University of Arizona College of Medicine — Tucson
Disclosure(s):
Rami Khoshaba, Medical Student: No financial relationships to disclose
Introduction: Semaglutide has recently garnered popularity for its primary indications in type 2 diabetes mellitus and refractory obesity. Recent studies have linked GLP-1 agonists to broader health benefits in cardiovascular, kidney, metabolic liver disease, and even neurological and psychiatric conditions. Given the context of newly emerging benefits and usage of GLP-1 agonists, the purpose of this present study is to investigate the potential effects of preoperative semaglutide use on postoperative outcomes of single-level lumbar spinal fusion.
Methods: A retrospective cohort study was conducted utilizing the Research Network in the TriNetX database. CPT ICD codes were used to identify patients ≥18 years old who underwent a single-level lumbar spinal fusion surgery. These patients were then further stratified into two groups: those prescribed semaglutide anytime between 1 year and 1 day before the index surgery (n=628), and those who were not (n=107,707). Both cohorts were each then 1:1 propensity score matched (n=627) for demographics and comorbidities. 90-day medical complications and 1-and-3-year surgical complications were analyzed. Risk difference, relative risk, and odds ratio were performed for each outcome within TriNetX, and statistical significance was set to p< 0.05.
Results: Patients prescribed semaglutide prior to single-level lumbar spinal fusion had significantly lower 90-day risk of unspecified infection (p=0.0194; RR = 0.592) and pseudoarthrosis (p < 0.0001; RR = 0.52), significantly lower 1-year risk of pseudoarthrosis (p < 0.0001; RR = 0.492), and a significantly lower 3-year risk of pseudoarthrosis (p < 0.0001; RR = 0.604) and revision surgery (p=0.007; RR = 0.414, 95% CI: 0.213, 0.804).
Conclusion : Semaglutide may play a protective role in improving lumbar fusion outcomes in addition to metabolic management. No associations were found between perioperative use of Semaglutide and an increased risk for postoperative complications.