ReviewEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
GLP-1 receptor agonists and outcomes after cervical spine fusion: a systematic review, meta-analysis, and evidence map of real-world evidence.
Review in 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
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Abstract
backgroundGlucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for type 2 diabetes and obesity, but their implications for outcomes after cervical spine fusion remain uncertain.
objectiveTo evaluate the association between GLP-1RA exposure and fusion-related, surgical, and medical outcomes after cervical spine fusion.
methodsWe conducted a PRISMA-guided systematic review, meta-analysis, and evidence map of GLP-1RA/incretin-based therapy exposure in cervical fusion or cervical decompression-and-fusion cohorts. PubMed/MEDLINE, Embase, Web of Science Core Collection, CENTRAL, and Scopus were searched from inception to 1 June 2026. Because several studies used overlapping databases, double-counting decisions were prespecified, and prioritized non-overlapping estimates were used for primary pseudarthrosis synthesis.
resultsTwelve retrospective cohorts published in 2025-2026 were included. In the primary pseudarthrosis synthesis, a combined TriNetX ACDF estimate was associated with lower odds of pseudarthrosis among GLP-1RA-exposed patients (OR, 0.52; 95% CI, 0.40-0.67), whereas an independent MarketScan ACDF estimate showed a neutral association (OR, 0.86; 95% CI, 0.56-1.32). The ACDF subgroup estimate was 0.65 (95% CI, 0.40-1.06; I
conclusionsObservational evidence suggests procedure-specific rather than class-wide associations after cervical spine fusion. For anterior cervical surgery/ACDF, evidence was collectively inconclusive, with estimates ranging from lower-risk to neutral, whereas a semaglutide-specific PCF cohort showed higher pseudarthrosis and dysphagia signals. These findings are hypothesis-generating and require validation in procedure-specific studies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.