Medical Student The University of Texas Medical Branch Galveston, Texas, United States
Introduction: Pseudarthrosis is the failure of bony union following arthrodesis. High A1c and BMI can lead to increased rates of pseudarthrosis through the buildup of plaques in the microvasculature surrounding the ligamentous and bony segments of the spine. With the rising popularity of GLP-1 agonists, the relationship between pseudarthrosis and this medication has yet to be explored.The objective was to investigate the effect of GLP-1 agonists on single level lumbar fusion pseudarthrosis rates.
Methods: TriNetX, a national research network, was retrospectively queried to identify 59,077 PLIF/TLIF patients between 2004 and 2022. Of these patients, 888 had a prescription for GLP-1 agonists from 6 months before the surgery to 6 months after the surgery. 58,018 did not have a prescription for GLP-1 agonists in that period. One-to-one propensity score matching for age, sex, race, comorbidities, BMI, and A1c was conducted to balance cohorts. The incidence of pseudarthrosis was then assessed within the six-month, one-year, and two-year postoperative periods.
Results: After propensity score matching, there were 885 patients in each cohort. Patients that took a GLP-1 agonist had lower odds of developing pseudarthrosis six months [odds ratio (OR): 0.69, 95% confidence interval (CI): 0.51-0.87], one year [OR: 0.56, 95% CI: 0.41-0.77], and two years (OR: 0.65, 95% CI: 0.48–0.86) following a PLIF/TLIF procedure.
Conclusion : Our study demonstrates that perioperative use of GLP-1 agonists is associated with significantly lower odds of developing pseudarthrosis following PLIF/TLIF procedures. These findings suggest a potential therapeutic benefit of GLP-1 agonists in enhancing spinal fusion outcomes and warrant further prospective studies to confirm these results and explore the underlying mechanisms.
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