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Life sciences · Review
European Spine Journal · August 8, 2026
Encouraging direction, but not yet definitive.
This systematic review of eight retrospective cohort studies (311,402 ACDF patients, 8,182 GLP-1RA users) reports that perioperative GLP-1RA use is associated with significantly lower odds of pseudarthrosis at 6, 12, and 24 months post-operatively. Evidence for other complications (reoperation, dysphagia, venous thromboembolism, readmission) remains heterogeneous and inconclusive, precluding firm conclusions about broader safety or efficacy.
Systematic review and random-effects meta-analysis of retrospective cohort studies. Patients undergoing anterior cervical discectomy and fusion, stratified by perioperative GLP-1RA use (users matched to non-users). Inclusion limited to observational cohort studies in humans.. Intervention: Perioperative glucagon-like peptide-1 receptor agonist (GLP-1RA) use. Compared with: Non-use of GLP-1RA (matched controls). n = 311,402. Not specified in abstract.
Lower odds of pseudarthrosis at 6 months in GLP-1RA users: OR = 0.60 (95% CI: 0.52–0.71; I² = 16.6%) Lower odds of pseudarthrosis at 12 months: OR = 0.62 (95% CI: 0.53–0.73; I² = 39.1%) Lower odds of pseudarthrosis at 24 months: OR = 0.67 (95% CI: 0.57–0.79; I² = 34.9%)
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
GLP-1RA use during the perioperative period appears associated with a 30–40% relative reduction in pseudarthrosis risk following ACDF; however, findings for other postoperative complications are inconsistent, and the observational design precludes causal inference. Clinicians should consider this emerging signal while awaiting prospective data.
Systematic review of 8 retrospective cohort studies (311,402 patients) demonstrates consistent, significant reduction in pseudarthrosis odds with GLP-1RA use at 6, 12, and 24 months, but evidence for other complications remains heterogeneous and inconclusive, limiting practice-changing strength.
As stated by the source record.
Quoted from the source exactly as published.
GLP-1RA use during the perioperative period appears associated with a 30–40% relative reduction in pseudarthrosis risk following ACDF; however, findings for other postoperative complications are inconsistent, and the observational design precludes causal inference. Clinicians should consider this emerging signal while awaiting prospective data.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Objective Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly prescribed for type 2 diabetes mellitus and obesity. Their metabolic, anti-inflammatory, and osteogenic effects raise important questions regarding their influence on spinal fusion. To date, no systematic review has specifically investigated how GLP-1RAs influence outcomes following the common anterior cervical discectomy and fusion (ACDF). This study aimed to evaluate the association between perioperative GLP-1RA use and outcomes following ACDF. Methods Following PRISMA guidelines, MEDLINE, Embase, PubMed, and the Cochrane Library were searched from inception to February 2026 for studies evaluating GLP-1RA exposure in the context of ACDF. Eligible studies included human observational cohort studies. Data were extracted independently by two reviewers. Results Eight retrospective cohort studies analysing 311,402 ACDF patients were included, of whom 8,182 were GLP-1RA users matched to non-users. Random-effects meta-analysis demonstrated significantly lower odds of pseudarthrosis among GLP-1RA users at 6 months (OR = 0.60, 95% CI: 0.52 to 0.71; I² = 16.6%), 12 months (OR = 0.62, 95% CI: 0.53 to 0.73; I² = 39.1%), and 24 months (OR = 0.67, 95% CI: 0.57 to 0.79; I² = 34.9%). Findings for reoperation, dysphagia, deep vein thrombosis, and readmission were heterogeneous and inconsistent across studies. Conclusion Perioperative GLP-1RA use was associated with lower odds of pseudarthrosis. However, evidence regarding other postoperative complications remains inconclusive. Future prospective studies are required to further elucidate the impact of GLP-1RA use on ACDF outcomes. Level of evidence Level III, therapeutic study.
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