Document Type
Article
Publication Date
11-20-2025
Abstract
CONTEXT: Semaglutide, a glucagon-like protein-1 receptor agonist used in diabetes and obesity management, has demonstrated perioperative benefits in other surgical populations. However, its role in spine surgery remains unclear.
AIMS: This study aims to evaluate whether patients undergoing single-level lumbar fusion demonstrate: (1) fewer medical complications; (2) surgical complications; and (3) healthcare utilization as measured by readmissions and costs.
SETTINGS AND DESIGN: A retrospective cohort study using a national claims database from 2010 to 2021.
SUBJECTS AND METHODS: Patients with diabetes mellitus undergoing single‑level lumbar fusion were identified and matched 1:5 using propensity scores based on age, sex, body mass index, smoking status, diabetes‑related complications, insulin/metformin use, and Elixhauser Comorbidity Index (semaglutide: N =3452; controls: N =15,486). Outcomes included 90‑day medical/surgical complications, readmissions, and costs. Multivariate logistic regression was used to calculate odds ratios, 95% confidence intervals, and P values, with statistical significance set at P < 0.003 after Bonferroni correction.
STATISTICAL ANALYSIS USED: Multivariate logistic regression for binary outcomes; cost comparisons conducted with appropriate statistical adjustments.
RESULTS: No significant differences were observed in rates of cerebrovascular accidents, myocardial infarctions, venous thromboembolism, pneumonia, hypoglycemia, or surgical site infections (SSIs) (P > 0.05 for all). Semaglutide users had significantly lower 90‑day readmission rates (8.7% vs. 11.4%, P < 0.0001) and reduced 90‑day costs‑of‑care (P < 0.0001). A trend toward fewer SSIs was noted (2.5% vs. 3.2%, P = 0.018), though not statistically significant.
CONCLUSIONS: Semaglutide use before single-level lumbar fusion is associated with reduced 90-day readmissions and costs without increasing complication risk.
Recommended Citation
Ng, Mitchell K.; Mastrokostas, Paul G.; Rodriguez, Ariel N.; Razi, Abigail; Mastrokostas, Leonidas E.; Emara, Ahmed K.; Ford, Brian T.; Xu, Jacquelyn J.; Dalton, Jonathan; Narayanan, Rajkishen; Kepler, Christopher K.; Hilibrand, Alan S.; Vaccaro, Alex R.; Monsef, Jad Bou; and Razi, Afshin E., "Semaglutide Use Before Single-Level Lumbar Fusion Associated With Fewer Readmissions and 90-Day Costs" (2025). Rothman Institute Papers. Paper 305.
https://jdc.jefferson.edu/rothman_institute/305
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Language
English
Comments
This article is the author's final published version in the Journal of Craniovertebral Junction and Spine, Volume 16, Issue 4, October-December 2025, Pages 401-407.
The published version is available at https://doi.org/10.4103/jcvjs.jcvjs_156_25. Copyright © 2025 Journal of Craniovertebral Junction and Spine | Published by Wolters Kluwer ‑ Medknow.