Related Experiment Video
Updated: Sep 19, 2026
Novel Mini-open Transforaminal Lumbar Interbody Fusion
Published on: June 6, 2025
Do Preoperative Glucagon-Like Peptide-1 Receptor Agonists Influence Lumbar Fusion Outcomes? A Systematic Review and
Matheus Loiola Magalhães Alves1, Antônio Olímpio da Silva Moura Costa2, Julia do Vale Moura Costa3
1Department of Medicine, Zarns University Center, Salvador, Bahia, Brazil matheusloiola10@gmail.com.
Background:
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used in patients with obesity and type 2 diabetes, but lumbar fusion-specific associations with postoperative outcomes remain uncertain.
Objective:
To evaluate the association between preoperative GLP-1RA exposure and surgical and postoperative outcomes in adults undergoing lumbar fusion.
Methods:
PubMed, Embase, and the Cochrane Library were searched from inception through 14 May 2026. Comparative studies of adults undergoing lumbar fusion with and without preoperative GLP-1RA exposure were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I). Random-effects meta-analyses generated odds ratios with 95% confidence intervals. The protocol was prospectively registered in PROSPERO (CRD420261414637).
Results:
Seven retrospective cohorts involving 28,525 patients were included; 6 used propensity score matching or another matching strategy. No statistically significant associations were observed between preoperative GLP-1RA exposure and reoperation or revision (OR: 0.74, 95% CI: 0.44-1.24; P = 0.25), postoperative infection (OR: 0.83, 95% CI: 0.68-1.00; P = 0.05), wound complications (OR: 0.86, 95% CI: 0.65-1.12; P = 0.26), or postoperative respiratory complications (OR: 1.08, 95% CI: 0.63-1.84; P = 0.69). Deep vein thrombosis, pulmonary embolism, and unplanned emergency department visits also did not differ significantly. All included studies were observational and predominantly used large administrative data sources.
Conclusions:
Across the evaluated outcomes, the available observational evidence did not identify a signal of increased postoperative risk associated with preoperative GLP-1RA exposure after lumbar fusion. Prospective studies with standardized exposure definitions and perioperative management protocols are warranted to confirm these findings and better define their clinical implications.
Clinical Relevance:
Current observational evidence does not establish preoperative GLP-1RA exposure alone as an independent risk factor for adverse outcomes after lumbar fusion.
