Semaglutide use before single-level lumbar fusion associated with fewer readmissions and 90-day costs.

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: 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) ( Conclusions: Semaglutide use before single-level lumbar fusion is associated with reduced 90-day readmissions and costs without increasing complication risk.