ArticleInternational journal of spine surgery2026
Patients on Long-Term Preoperative Glucagon-Like Peptide-1 Receptor Agonist Therapy Show Significant Reductions in Postoperative Complications After Elective Laminectomy in Overweight Adults: A Propensity-Matched Study.
Article in International journal of spine surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPatients with obesity undergoing spine surgery are at increased risk for postoperative complications. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used for diabetes and weight management, but their perioperative impact in spine procedures is not well defined. This study evaluated whether long-term preoperative GLP-1 RA therapy is associated with improved postoperative outcomes after elective laminectomy in overweight adults.
methodsA retrospective cohort study was performed using the TriNetX research network across 72 US health systems. Overweight or obese adults undergoing elective cervical, thoracic, or lumbar laminectomy were divided into GLP-1 RA users (≥6 months of continuous preoperative therapy) and nonusers. Propensity score matching (1:1) was performed across 33 demographic and clinical variables. Outcomes assessed at 90 days and 1 year included sepsis, acute kidney injury, deep vein thrombosis, myocardial infarction, pneumonia, stroke, wound dehiscence, surgical site infection, postlaminectomy syndrome, and all-cause mortality.
resultsMatched cohorts included 5680 patients per group. GLP-1 RA therapy was associated with significantly lower odds of sepsis (OR 0.38 at 90 days; 0.52 at 1 year), deep vein thrombosis (0.26; 0.41), wound dehiscence (0.38; 0.47), surgical site infection (0.37; 0.43), and mortality (0.30; 0.48; all
conclusionsLong-term preoperative GLP-1 RA therapy was associated with reduced postoperative infectious, thrombotic, and wound-related complications, as well as lower mortality, following elective laminectomy in overweight adults. These findings support the potential role of GLP-1 RA use in preoperative optimization strategies for high-risk surgical populations. CLINICAL RELEVANCE: Identifying modifiable risk factors is essential for improving outcomes in overweight or obese patients undergoing spine surgery. This study suggests that GLP-1 RAs may serve as a practical and effective preoperative optimization tool to reduce complications and enhance postoperative recovery. LEVEL OF EVIDENCE: 3:
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