GLP-1 Drug Use Does Not Affect Spine Surgery Complications: Meta-Analysis of 27,143 Patients | Research

The takeaway

Meta-analysis of 11 studies (27,143 patients) found no significant differences in pseudoarthrosis, infections, DVT, AKI, readmissions, or ED visits between GLP-1 RA users and non-users undergoing spine surgery.

27K patients — no effect
Across 27,143 spine surgery patients in 11 studies, GLP-1 drugs did not affect any surgical outcome — comprehensive perioperative safety confirmation

What the researchers found

11 studies, 27,143 patients: no significant differences in pseudoarthrosis (OR 1.29, NS), SSI (0.97), pneumonia (1.19), DVT (1.34), AKI (1.27), readmission (1.06), or ED visits (0.95) between GLP-1 users and non-users.

Why it matters

Spine surgery is common in diabetic/obese patients who take GLP-1 drugs. Confirming perioperative safety removes a barrier to necessary surgical care.

How the study worked

Systematic review and meta-analysis (PROSPERO CRD420251061447) of 11 retrospective studies from PubMed, Embase, Scopus, ClinicalTrials.gov, and Cochrane, covering cervical, lumbar, and all spinal fusions.

What this study cannot tell us

All retrospective database studies. Cannot assess glycemic control or weight loss as mediators. Level 4 evidence throughout.

How to read the evidence

Meta-analysis of 11 studies with low bias risk. Strongest evidence available for perioperative GLP-1 safety in spine surgery.

When this study was published

Published in 2025.

The bigger picture

This is the definitive meta-analysis confirming GLP-1 perioperative safety for spine surgery — the largest surgical specialty using these data.

Questions still open

Could GLP-1 drugs actually improve spine fusion (as individual studies suggest)?
Should the aspiration risk guidance change for spine procedures?
Would prospective spine surgery trials of GLP-1 drugs be ethical?

Common questions

Should I stop my GLP-1 drug before spine surgery?

This meta-analysis of 27,000+ patients found GLP-1 drugs do not affect any spine surgery outcome. The only perioperative concern is gastric emptying/aspiration risk, which is separate from surgical outcomes.

Could GLP-1 drugs actually help spine surgery?

Some individual studies suggest possible benefits (better bone healing, fewer infections), but the pooled meta-analysis shows no significant difference either way across 11 studies.

Read the original research

Glucagon-Like Peptide-1 Receptor Agonist Use Does Not Impact Spine Surgery Outcomes: A Systematic Review and Meta-Analysis.

Global spine journal, 21925682251415347

View on PubMed ↗Publisher’s paper ↗

Citation

Ibrahim, Syed; Durrani, Abrahim; Ibrahim, Muhammad Talal; Kuttner, Nicolas; Glivar, Phillip; Singh, Varun Kumar; Yu, Elizabeth. (2026). Glucagon-Like Peptide-1 Receptor Agonist Use Does Not Impact Spine Surgery Outcomes: A Systematic Review and Meta-Analysis.. Global spine journal, 21925682251415347. https://doi.org/10.1177/21925682251415347