Semaglutide treatment does not increase surgical complications after cervical spine fusion in diabetic patients | Research

The takeaway

Propensity-matched analysis of 596 diabetic patients shows semaglutide use within 6 months before cervical spine fusion was not associated with increased surgical complications, readmissions, or reoperation rates.

No perioperative risk increase
Semaglutide use within 6 months of cervical spine fusion showed no increased surgical complications—reassuring for the growing number of spine surgery patients on GLP-1 drugs

What the researchers found

Surgical complications: OR 1.26 (0.83-1.93, NS). 30-day readmission: OR 0.83 (NS). 90-day readmission: OR 0.89 (NS). 298 matched pairs. PearlDiver Database 2010-2021.

Why it matters

Surgeons are increasingly encountering patients on GLP-1 drugs. This study provides reassurance that semaglutide does not impair surgical healing or increase complications in spine surgery.

How the study worked

Retrospective propensity-matched cohort from PearlDiver Database. 596 T2DM patients (298 semaglutide, 298 control). Matched on age, sex, CCI. Multivariate regression.

What this study cannot tell us

Retrospective. Short-term (<6 month) outcomes only. PearlDiver Database limitations. Cannot assess long-term fusion outcomes. Relatively small matched cohort.

How to read the evidence

Propensity-matched retrospective study with appropriate methodology. Good surgical safety evidence.

When this study was published

Published in 2025; data 2010-2021.

The bigger picture

This adds to accumulating evidence that GLP-1 drugs are perioperatively safe. Combined with spine-specific bone healing benefits (from the pseudoarthrosis study), GLP-1 drugs may actually benefit spine surgery patients.

Questions still open

Do GLP-1 drugs affect long-term fusion rates?
Should semaglutide be held before spine surgery?
Would combining with the pseudoarthrosis data support continued perioperative GLP-1 use?

Common questions

Is it safe to have spine surgery while on semaglutide?

This study of 596 diabetic patients found no increased risk of surgical complications, wound problems, or need for reoperation when patients used semaglutide before cervical spine fusion. This suggests GLP-1 drugs do not impair surgical healing in the spine.

Should I stop semaglutide before surgery?

For surgical complication risk specifically, this study suggests semaglutide does not need to be stopped. However, GLP-1 drugs do slow stomach emptying (anesthesia concern), so discuss the timing of your last dose with your anesthesia team. The surgical healing concern appears unfounded based on this data.

Read the original research

No Difference in Short-term Surgical Outcomes From Semaglutide Treatment for Type 2 Diabetes Mellitus After Cervical Decompression and Fusion: A Propensity Score-matched Analysis.

Spine, 50(8), 515-521

View on PubMed ↗Publisher’s paper ↗

Citation

Tao, Xu; Ranganathan, Sruthi; Van Halm-Lutterodt, Nicholas; Garcia-Vargas, Julia; Wu, Andrew; Karnati, Janesh; Shankar, Sachin; Agyeman, Nana; Ashraf, Ahmed; Barve, Parikshit; Childress, Kelly; Adogwa, Owoicho. (2025). No Difference in Short-term Surgical Outcomes From Semaglutide Treatment for Type 2 Diabetes Mellitus After Cervical Decompression and Fusion: A Propensity Score-matched Analysis.. Spine, 50(8), 515-521. https://doi.org/10.1097/BRS.0000000000005099