Spinal surgery patients who were already taking GLP-1 receptor agonists spent one fewer day in the hospital on average compared to matched controls, with no differences in complication rates.
1 day shorter stayGLP-1RA users had a median 3-day hospital stay after spinal surgery vs 4 days for matched controls (p=0.036)
What the researchers found
Preoperative GLP-1 receptor agonist use was associated with a significant reduction in median postoperative length of stay: 3 days vs 4 days (p=0.036). This effect was particularly pronounced among patients undergoing lumbar fusion.
No significant differences were observed between GLP-1RA users and controls in operating room time, 90-day reoperation rates, 90-day readmission rates, or nonroutine discharge rates, suggesting that GLP-1RA use did not negatively impact other surgical outcomes.
Why it matters
Hospital length of stay after spinal surgery is a major driver of healthcare costs and patient recovery. If GLP-1 receptor agonists — already taken by millions for diabetes and weight loss — also help patients recover faster from surgery, it could have significant implications for surgical planning and preoperative optimization, especially for the large population of overweight and diabetic patients who commonly need spinal procedures.
How the study worked
This was a retrospective, propensity score-matched analysis of adult patients undergoing spinal decompression and/or fusion at an urban academic spine center over 5 years. A 1:4 nearest-neighbor matching algorithm paired 277 GLP-1RA users with 1,108 controls, matching on age, sex, BMI, procedure type, comorbidities, and use of other diabetes medications. Outcomes were assessed using multivariate logistic regression for binary outcomes and the Mann-Whitney U test for continuous variables.
What this study cannot tell us
This is a retrospective single-center study, which limits generalizability and cannot prove causation. The study could not determine whether the shorter hospital stays were specifically due to GLP-1RA pharmacological effects or related lifestyle factors. The duration and dosing of GLP-1RA use before surgery were not analyzed. Additionally, the study could not differentiate between specific GLP-1RA drugs, and the predominantly female cohort (62%) may not represent all spinal surgery patients.
How to read the evidence
This is a retrospective propensity score-matched cohort study from a single academic center. While the matching methodology strengthens the comparison, the observational design and single-center nature limit the strength of evidence. The authors appropriately call for prospective multi-institutional validation.
When this study was published
Published in 2025, this is very recent research addressing a timely question about the surgical implications of increasingly common GLP-1RA medications.
The bigger picture
This study adds to a growing body of evidence exploring unexpected benefits of GLP-1 receptor agonists beyond glucose control and weight loss. Previous research has shown reduced complications after hip and knee replacement in GLP-1RA users. This spine surgery data suggests the benefits may extend across surgical specialties, possibly due to GLP-1RA's anti-inflammatory effects, metabolic improvements, or weight reduction prior to surgery.
Questions still open
- Does the duration of GLP-1RA use before surgery affect the magnitude of benefit on hospital length of stay?
- What biological mechanisms might explain how GLP-1 drugs help patients recover faster from spinal surgery?
- Would prospective studies confirm this association and reveal whether the shorter stays translate into better long-term outcomes?
Common questions
Should I keep taking my GLP-1 drug (like Ozempic or Mounjaro) before spinal surgery?
Why might GLP-1 drugs help with surgical recovery?
Read the original research
Glucagon-like peptide-1 receptor agonist use prior to spinal surgery results in reduced postoperative length of stay: A propensity-score matched analysis.
North American Spine Society journal, 22, 100612
Citation
Goldman, Samuel N; Mani, Kyle; Scharfenberger, Thomas; Kleinbart, Emily; Hui, Aaron T; De la Garza Ramos, Rafael; Fourman, Mitchell S; Eleswarapu, Ananth S. (2025). Glucagon-like peptide-1 receptor agonist use prior to spinal surgery results in reduced postoperative length of stay: A propensity-score matched analysis.. North American Spine Society journal, 22, 100612. https://doi.org/10.1016/j.xnsj.2025.100612