Study Design: Retrospective cohort study. Objective: To evaluate postoperative outcomes following posterior cervical spine surgery among nondiabetic patients prescribed glucagon-like peptide-1 (GLP-1) receptor agonists compared with a matched cohort not receiving GLP-1 therapy. Summary of Background Data: Obesity increases the risk of complications after posterior cervical spine surgery, including wound complications, infection, and venous thromboembolism. Lifestyle-based weight management is often difficult to sustain, while bariatric surgery achieves durable weight loss but carries risks of malabsorption and nutritional deficiencies. GLP-1 receptor agonists, originally developed for the management of diabetes, are increasingly prescribed for weight loss in nondiabetic patients, making it important to clarify their perioperative implications. The impact of GLP-1s on outcomes after posterior cervical procedures in nondiabetic patients remains unclear. Methods: The PearlDiver Mariner database (2010–2023) was queried for nondiabetic patients undergoing posterior cervical spine surgery. Patients prescribed GLP-1s were 1:1 propensity-matched to controls by demographics and comorbidities. Surgical and medical outcomes were assessed at 90 days. Long-term outcomes, including mortality at 1-year and 2-year revision, surgical site infection, and deep infection, were assessed. Odds ratios (ORs) were created using logistic regression analyses. Results: A total of 136,571 nondiabetic patients underwent posterior cervical surgery. After matching, 1,719 patients were included in each cohort. GLP-1 use was associated with reduced odds of emergency department visits (OR: 0.71; 95% CI: 0.58–0.87; P =0.001) and hospital admission (OR: 0.54; 95% CI: 0.41–0.70; P <0.001) within 90 days. No significant differences were observed in other complications at 90 days or 2 years. Conclusion: GLP-1 use in nondiabetic patients was associated with reduced emergency department utilization and hospital admission within 90 days of posterior cervical spine surgery. GLP-1 therapy was not associated with increased complication risk, supporting its perioperative safety and suggesting a potential role in perioperative optimization in this population.
Rivera et al. (Thu,) studied this question.