Researchers looked at patients taking GLP-1 drugs (like Ozempic or Wegovy, used for weight loss and diabetes) before having lumbar fusion spine surgery. They compared these patients to similar patients who didn’t take the drug. The study found that patients on GLP-1 drugs had fewer complications after surgery, including fewer blood clots, infections, and deaths within one year. While these results are encouraging, doctors still need to understand exactly why this drug helps and study it more carefully before making it a standard recommendation.

The Quick Take

  • What they studied: Whether patients taking GLP-1 receptor agonist drugs (weight loss and diabetes medications) before spine fusion surgery had better outcomes and fewer problems after surgery compared to patients not taking these drugs.
  • Who participated: Thousands of patients from a large medical database who had lumbar fusion spine surgery. Researchers carefully matched patients on the GLP-1 drug with similar patients not taking it, considering factors like age, weight, diabetes, heart disease, and other health conditions.
  • Key finding: Patients taking GLP-1 drugs before surgery had significantly fewer serious complications. Death rates were less than half (2.1% vs 4.6%), blood clots were reduced by about 30%, infections were reduced by about 20%, and the rate of bones not fusing properly dropped from 13.8% to 8.9%.
  • What it means for you: If you’re considering spine fusion surgery and take a GLP-1 drug for weight loss or diabetes, this research suggests your surgery outcomes may be better than average. However, don’t start taking these drugs just for surgery—talk to your doctor about whether you’re a good candidate for this medication based on your overall health.

The Research Details

This was a retrospective cohort study, which means researchers looked backward at medical records of patients who had already had spine surgery. They used a large database called TriNetX that contains information from many hospitals and clinics across the United States. Researchers identified all patients who had lumbar fusion surgery over a 20-year period and divided them into two groups: those who had taken GLP-1 drugs in the year before surgery and those who hadn’t.

To make the comparison fair, researchers used a statistical technique called propensity score matching. This is like pairing up patients so that each person taking the GLP-1 drug was matched with a very similar person not taking it. They matched patients based on 18 different factors including age, gender, race, weight, diabetes status, heart disease, kidney disease, sleep apnea, and other health conditions. This matching helps ensure that any differences in outcomes are due to the GLP-1 drug and not just because the groups were different to begin with.

Researchers then compared what happened to both groups during the first year after surgery, looking at rates of complications like blood clots, infections, heart problems, and whether the bones fused properly.

This research approach is important because it helps answer a real-world question: do patients already taking these popular drugs have better surgical outcomes? By using a large database and carefully matching similar patients, the researchers could control for many factors that might affect surgery outcomes. This makes the results more trustworthy than if they had simply compared all patients taking the drug to all patients not taking it, since those groups might have been very different to begin with.

Strengths of this study include the large sample size from multiple hospitals, careful matching of comparison groups, and looking at many different types of complications. The study was published in a peer-reviewed medical journal. Limitations include that it’s observational (not a controlled experiment where some people are randomly assigned to take the drug), so we can’t be completely certain the drug caused the better outcomes. The study also relied on medical records, which may not capture all information. Additionally, the reasons why patients were taking GLP-1 drugs (weight loss vs. diabetes) weren’t fully separated in the analysis.

What the Results Show

Patients taking GLP-1 drugs before surgery had significantly better outcomes across multiple measures. The most dramatic difference was in death rates: only 2.1% of GLP-1 users died within one year compared to 4.6% of non-users—less than half the death rate. This difference was statistically significant, meaning it’s very unlikely to have happened by chance.

Blood clots (pulmonary embolism) occurred in 1.1% of GLP-1 users versus 1.6% of non-users. Serious infections (sepsis) happened in 4.0% of GLP-1 users compared to 5.0% of non-users. These reductions were modest but still statistically significant. The most impressive finding was in pseudoarthrosis (when the bones don’t fuse together properly after surgery), which dropped from 13.8% in non-users to 8.9% in GLP-1 users—a reduction of about 36%.

Overall complications within 30 days of surgery were also lower in the GLP-1 group (9.5% vs 12.4%). The researchers found these benefits even after accounting for differences in weight, diabetes, and other health conditions between the groups.

The study also looked at several other complications. Patients taking GLP-1 drugs showed trends toward fewer heart-related problems and kidney issues after surgery, though these differences were smaller and less certain. The consistent pattern across multiple types of complications suggests the drug may have broad protective effects, rather than just helping with one specific problem.

This is one of the first studies to specifically examine GLP-1 drugs and spine surgery outcomes. Previous research has shown that GLP-1 drugs help with weight loss and blood sugar control, which are both factors that affect surgery recovery. This study suggests the benefits may go beyond just weight loss. Some research on other surgeries has shown that better weight control and blood sugar management improve outcomes, which aligns with these findings. However, most previous studies haven’t specifically looked at GLP-1 drugs before surgery, so this research adds new information to the field.

The biggest limitation is that this study is observational, not a randomized controlled trial. This means we can’t be completely certain the GLP-1 drug caused the better outcomes—it’s possible that patients taking these drugs were healthier or more health-conscious in other ways not measured in the study. The study couldn’t determine whether the benefits came from weight loss, better blood sugar control, or other effects of the drug. The research also didn’t include information about how long patients had been taking the drug, how much weight they lost, or how well their blood sugar was controlled. Additionally, the study only followed patients for one year, so we don’t know about longer-term outcomes. Finally, the reasons why patients were prescribed GLP-1 drugs (some for weight loss, some for diabetes) weren’t fully separated in the analysis.

The Bottom Line

Based on this research, if you’re already taking a GLP-1 drug and need spine fusion surgery, this is good news—your outcomes may be better than average. However, this study doesn’t recommend starting a GLP-1 drug just to prepare for surgery. If you’re considering spine surgery and your doctor thinks you might benefit from a GLP-1 drug for weight loss or diabetes management, this research adds to the reasons it might be helpful. Talk to your surgeon and primary care doctor about whether these drugs are appropriate for you. The evidence is moderate—the findings are encouraging but not yet definitive enough to change standard surgical practice.

This research matters most for people who are planning to have lumbar fusion spine surgery and are already taking or considering taking GLP-1 drugs. It’s also relevant for surgeons and anesthesiologists who care for patients on these medications. People with diabetes or obesity who need spine surgery should discuss this with their doctors. However, this research should NOT be used as a reason to start taking these drugs if you don’t otherwise need them. People with certain conditions (like a personal or family history of thyroid cancer) should not take GLP-1 drugs regardless of surgery plans.

If you’re already taking a GLP-1 drug before surgery, the benefits appear to show up in the first few weeks and months after surgery. The study measured outcomes at 30 days and one year, with benefits visible at both time points. If you’re considering starting a GLP-1 drug before planned surgery, most doctors would want you to be on it for at least several weeks to see benefits, though the ideal timing isn’t clear from this study.

Want to Apply This Research?

  • If you’re taking a GLP-1 drug and having spine surgery, track your weekly post-surgery complications using a simple checklist: fever, wound redness or drainage, unusual pain, swelling, difficulty breathing, or chest pain. Rate your overall recovery on a 1-10 scale weekly for the first 12 weeks.
  • Work with your healthcare team to maintain consistent GLP-1 medication use before and after surgery (as approved by your surgeon). Log your medication doses and any side effects. Set reminders for physical therapy exercises as recommended by your surgeon, since the study suggests better bone fusion may allow for more effective rehabilitation.
  • Create a long-term tracking system for the first year post-surgery: monthly check-ins on pain levels, mobility improvements, and any new symptoms. Document all follow-up appointments and imaging results. Share this data with your surgical team to monitor for pseudoarthrosis (bone fusion failure) and other delayed complications.

This research suggests an association between GLP-1 drug use and better spine surgery outcomes, but it does not prove that the drug causes these improvements. This study should not be used as a reason to start taking GLP-1 drugs if you don’t otherwise need them. Do not start, stop, or change any medications without talking to your doctor first. If you’re planning spine surgery and take a GLP-1 drug, inform your surgical team. This information is for educational purposes and should not replace medical advice from your healthcare provider. Individual results may vary based on your specific health situation.