No Difference in Short-Term Surgical Outcomes from Semaglutide Treatment for T2DM after Multi-Level Lumbar Spine Decompression and Fusion: A Propensity Score-Matched Analysis

Introduction: Semaglutide, a GLP-1 receptor agonist, is gaining popularity as a weekly injectable medication for the treatment of T2DM and obesity. Existing research indicates that higher levels of HbA1c are linked to fewer positive results after spine surgery. However, few publications exist evaluating the influence of semaglutide therapy on surgical complications. This study seeks to evaluate the impact of semaglutide treatment for Type 2 Diabetes Mellitus (T2DM) on the composite risk of short-term ( < 6 months) postoperative complications including, surgical site infection, wound complications, and reoperation in patients undergoing multi-level lumbar spine decompression and fusion in the United States.

Methods: The PearlDiver Database was queried from January 2010 to December 2021 for patients with a primary diagnosis of T2DM within 2 years prior to multi-level lumbar spine decompression and fusion. Patients with semaglutide treatment within 6 months before index surgery were propensity score-matched to patients without the treatment, i.e. control in a 1:1 ratio, employing age, gender, and Charlson comorbidity index (CCI) as matching covariates. A multivariate regression model was used, adjusting for confounding variables to investigate the impact of semaglutide treatment on postoperative surgical complications rate.

Results: The propensity score-matched cohort included 1108 patients (semaglutide cohort: 554, control cohort: 554). There were no statistically significant differences between cohorts in the composite measure of postoperative surgical complications following index surgery (OR 1.05, 95% CI 0.77-1.45, p = 0.808). Similarly, both 30-day (OR 0.73, 95% CI 0.49-1.08, p = 0.138) and 90-day readmission rate (OR 0.90, 95% CI 0.64-1.27, p = 0.601) were similar between both cohorts.

Conclusion : This study suggests that in patients with T2DM, semaglutide treatment is not associated with higher rates of adverse events after multi-level lumbar spine decompression and fusion. The effect of semaglutide use on long-term outcomes remains unknown.