Impact of glucagon-like peptide-1 receptor agonists on outcomes following anterior cervical discectomy and fusion: a systematic review and meta-analysis
In brief
GLP-1 agonist use cuts pseudarthrosis risk by about one-third after cervical fusion
In a meta-analysis of eight retrospective cohorts covering 311,402 anterior cervical discectomy and fusion patients, those taking GLP-1 receptor agonists (8,182 individuals) had roughly 40% lower odds of non-union at 6, 12 and 24 months compared with non-users. Rates of reoperation, dysphagia, clotting and readmission were mixed, so further prospective research is needed.
- Journal
- European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (Q1)
- Published
- 8 August 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 2, Moderate (CEBM 2a)
- Authors
- Dave Osinachukwu Duru, David Kwan Ryung Lee, Chloe Edmonds, Aron Abraham, Younis Peach, Philip K Louie
- PMID
- 42570103
- DOI
- 10.1007/s00586-026-10258-y
Why clinicians should know about it
- Picked for Endocrinology, Diabetes and Metabolism (paper of the day, 9 August 2026).
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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.