Semaglutide Use Is Associated With Decreased Length of Stay and Hospital Costs in Patients Undergoing Anterior Lumbar Interbody Fusion: A Retrospective Cohort Study.

BACKGROUND: Anterior lumbar interbody fusion (ALIF) is frequently performed to treat degenerative spine disease. Outcomes, however, may be affected by obesity and diabetes. Semaglutide, a glucagon-like peptide-1 receptor agonist, improves metabolic health and reduces inflammation, with emerging data suggesting it may aid postoperative recovery. Its specific impact on ALIF remains underexplored. This study evaluates the association between semaglutide use and postoperative complications, length of stay (LOS), and health care costs in ALIF patients. MATERIALS AND METHODS: We conducted a retrospective cohort study using the PearlDiver Mariner database from 2010 through 2022. Patients undergoing ALIF with active semaglutide prescriptions were propensity score-matched 1:5 to non-users based on age, sex, Elixhauser Comorbidity Index, obesity, tobacco use, and diabetes-related variables. Outcomes included 90-day complications, 2-year surgical complications, LOS, and total costs. Statistical analysis included chi-squared tests and multivariable logistic regression, with Bonferroni-adjusted significance set at< .003. RESULTS: A total of 2,939 patients were included in the final analysis (425 semaglutide users, 2,514 matched controls). No significant differences were observed in 90-day or 2-year complication rates between the groups. However, semaglutide users had a significantly shorter LOS by 0.6 days and incurred roughly $10,400 lower same-day surgical costs and about $9,700 lower 90-day postoperative costs (< .001 for all comparisons). CONCLUSION: Semaglutide use was associated with reduced LOS and health care costs in ALIF patients without increasing complication rates. These findings suggest a potential role for semaglutide in optimizing perioperative outcomes and reducing resource use. Further research is warranted to assess long-term benefits.