Diabetic patients on semaglutide before lumbar spine fusion had 24% fewer 90-day readmissions and lower costs compared to matched controls, with no increase in complications.
8.7% vs 11.4% readmission rateSemaglutide users had significantly fewer 90-day hospital readmissions after lumbar fusion surgery compared to matched controls, while maintaining comparable complication rates.
What the researchers found
Among 3,452 semaglutide users matched against 15,486 controls undergoing single-level lumbar fusion, semaglutide use was associated with significantly lower 90-day readmission rates (8.7% vs. 11.4%) and lower 90-day costs. No significant differences were found in rates of stroke, heart attack, blood clots, pneumonia, low blood sugar, or surgical site infections.
The study suggests semaglutide provides perioperative benefits for spine surgery patients with diabetes without increasing complication risk.
Why it matters
As semaglutide becomes one of the most prescribed medications worldwide, understanding its effects on surgical outcomes is crucial. This study provides reassuring evidence that patients on semaglutide can safely undergo lumbar spine surgery — and may actually experience better outcomes with fewer readmissions and lower costs. This is particularly important given the large number of diabetic patients who need spine surgery.
How the study worked
A retrospective cohort study using a national claims database (2010–2021). Semaglutide users (N=3,452) were propensity-matched 1:5 to controls (N=15,486) based on age, sex, BMI, smoking, diabetes complications, medication use, and comorbidity index. Outcomes were analyzed using multivariate logistic regression with Bonferroni correction (significance at P<0.003).
Who was studied
Diabetic patients undergoing single-level lumbar fusion (3,452 semaglutide users vs. 15,486 matched controls)
What this study cannot tell us
Retrospective design cannot prove causation. Claims database data lacks clinical detail on semaglutide dosing, duration, and timing relative to surgery. The Bonferroni correction makes significance thresholds conservative. Database limitations may lead to coding inaccuracies. The study period (2010–2021) captures early semaglutide use patterns that may not reflect current prescribing.
How to read the evidence
This is a large retrospective cohort study with propensity-score matching and rigorous statistical correction. While it cannot establish causation, the large sample size and careful matching provide strong observational evidence.
When this study was published
Published in 2025 using data from 2010–2021, this study is timely as clinical guidelines around perioperative GLP-1 RA management are actively evolving.
The bigger picture
There has been concern in surgical communities about whether GLP-1 medications should be stopped before surgery due to potential anesthesia risks. This study adds to growing evidence that semaglutide may actually improve surgical outcomes, potentially through better blood sugar control, reduced inflammation, or weight management benefits — challenging the narrative that these drugs are risky around surgery time.
Questions still open
- Should semaglutide be continued or initiated before elective spine surgery in diabetic patients?
- What specific mechanisms drive the reduced readmission rates — better glycemic control, weight loss, or anti-inflammatory effects?
- Do these benefits extend to multi-level fusions and other spine procedures?
Common questions
Is it safe to take semaglutide before spine surgery?
Why might semaglutide improve surgical outcomes?
Read the original research
Semaglutide use before single-level lumbar fusion associated with fewer readmissions and 90-day costs.
Journal of craniovertebral junction & spine, 16(4), 401-407
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, Alexander R; Monsef, Jad Bou; Razi, Afshin E. (2025). Semaglutide use before single-level lumbar fusion associated with fewer readmissions and 90-day costs.. Journal of craniovertebral junction & spine, 16(4), 401-407. https://doi.org/10.4103/jcvjs.jcvjs_156_25