Association of glucagon-like peptide-1 agonist therapy with postsurgical outcomes following multilevel correction for adult spinal deformity: a propensity score-matched analysis.

Abstract

Retrospective cohort study. This study aimed to examine outcomes in patients with adult spinal deformity (ASD) undergoing deformity correction with and without glucagon-like peptide-1 receptor agonist (GLP-1A) therapy. GLP-1As, widely used in diabetes management, have recently been linked to reduced postoperative complications. However, their role in spinal surgery remains underexplored. This multicenter, retrospective cohort study was conducted using the TriNetX Global Collaborative Database (2005-2025) utilizing Current Procedural Terminology and International Classification of Diseases, 10th Revision, codes for patients undergoing spinal deformity correction because of ASD. Patients prescribed GLP-1As within 1 year of surgery were 1:1 propensity-score matched with those who were not using GLP-1As. The cohort was matched according to patient demographics and comorbidities. Surgical outcomes between groups were analyzed at 1- and 2-year intervals. Significance was defined as p <0.05. At 1 and 2 years following surgery, patients taking GLP-1As exhibited significantly lower odds of pseudoarthrosis, hardware failures, wound dehiscence, infections, thromboembolic events, readmissions, and mortality. The findings reveal a significant reduction in the rates of pseudoarthrosis, hardware failure, readmission, and mortality in patients treated with GLP-1As. These results align with the recent literature, pointing to a potential complementary therapy in ASD management. Further studies characterizing the mechanism by which GLP-1As affect postoperative spinal physiology are warranted to assess their utility in optimizing patient outcomes.