Key result
Higher beta-blocker exposure is linked to ~2.7-fold higher reoperation risk after lumbar spinal fusion.
Why the study?
The impact of beta-blocker exposure on postoperative outcomes after lumbar spinal fusion remains incompletely understood, with limited clinical evidence in spine surgery.
Does high-frequency beta-blocker exposure increase the risk of postoperative complications in adult patients undergoing single-level lumbar spinal fusion?
Cohort
Does high-frequency beta-blocker exposure increase the risk of postoperative complications in adult patients undergoing single-level lumbar spinal fusion?
Hazard Ratio: 2.726 (95% CI 1.633–4.551)
Chronic high-frequency beta-blocker exposure is associated with increased risks of reoperation, pseudarthrosis, and wound-related complications following single-level lumbar spinal fusion.
May warrant caution with beta-blockers around lumbar fusion; hypothesis-generating for impaired healing and needs prospective validation.
Background Beta-blockers are commonly prescribed for cardiovascular conditions, yet their impact on postoperative outcomes after spinal fusion remains incompletely understood. Preclinical studies suggest that β-adrenergic blockade may influence angiogenesis and tissue repair. However, clinical evidence in spine surgery remains limited. Objective To evaluate the association between beta-blocker exposure and postoperative complications, including pseudarthrosis, reoperation, and wound-related events, after single-level lumbar spinal fusion. Methods A retrospective cohort study was conducted using a large real-world database (2002−2022). Adult patients aged ≥40 years undergoing single-level lumbar spinal fusion, with or without interbody fusion, were identified using CPT codes 22,633, 22612, 22558, and 22,630. Patients were stratified into high-frequency (≥6 prescriptions) and low-frequency (≤1 prescription) beta-blocker exposure groups. Propensity score matching was applied to reduce baseline confounding. Cox proportional hazards models estimated risks of pseudarthrosis and reoperation, while logistic regression and Kaplan-Meier analyses assessed wound-related complications. Results After propensity score matching, higher beta-blocker exposure was associated with increased risk of reoperation (HR = 2.726, 95% CI: 1.633–4.551) and pseudarthrosis (HR = 1.341, 95% CI: 1.057–1.701). Patients in the high-exposure group also demonstrated higher rates of wound-related complications, including hematoma or seroma formation (HR = 6.537, p < .001). Infection and wound drainage were also more frequently observed in the high-exposure group, whereas mechanical failure rates did not differ significantly. Conclusions Higher beta-blocker exposure was associated with increased risks of reoperation, pseudarthrosis, and wound-related complications after lumbar spinal fusion. Further prospective studies are warranted to clarify causality and mechanisms.
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Chang et al. (2026) conducted a cohort in Single-level lumbar spinal fusion. High-frequency beta-blocker exposure vs. Low-frequency beta-blocker exposure was evaluated on reoperation (HR 2.726, 95% CI 1.633-4.551). Higher beta-blocker exposure was associated with an increased risk of reoperation (HR 2.726; 95% CI 1.633-4.551) and pseudarthrosis after single-level lumbar spinal fusion.
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