Complete radiologic and clinical reversal of lumbar spinal epidural lipomatosis via GLP-1 agonist.

Wurm LM, Koch P, Ertel W, Laue D

Journal of surgical case reports12 Feb 2026

PMID41694436PMCIDPMC12900073DOI10.1093/jscr/rjag052PepBankPUB-41694436

Summary

Spinal epidural lipomatosis (SEL) is a rare cause of lumbar canal stenosis, typically linked to obesity or corticosteroid use. Severe cases often require decompression. We report a 48-year-old man with chronic low back pain and morbid obesity (153 kg) who presented with extensive SEL and critical stenosis. Previous conservative therapies failed. A non-surgical strategy using GLP-1-induced weight loss (semaglutide) and medical cannabis for pain control was initiated. Over a follow-up of one year, his weight dropped to 93.8 kg, with major improvement in pain and mobility. MRI demonstrated near-complete regression of epidural fat and resolution of stenosis, avoiding surgery. The patient remained neurologically intact. This appears to be the first documented case of SEL reversal achieved through medical weight loss alone. The findings highlight GLP-1 agonists as a potential therapeutic option in obesity-related spinal disorders and support cannabis as part of non-opioid pain management.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study6

No result from this study comes from a test of the peptide.

Studies that did not test the peptide alone6

In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Semaglutide.

01HumanNot a test of Semaglutide aloneCase report or seriesEfficacy outcome
In a man with morbid obesity and spinal epidural lipomatosis, a regimen of semaglutide with medical cannabis was followed by a drop in weight to 93.8 kg over one year.
In plain wordsIn one man with obesity, weight fell to 93.8 kg over one year on a regimen of semaglutide and medical cannabis.
Peptide
Semaglutide
Outcome
DecreaseBody weight over one year
Study
n = 1
Outcome group
Body weight · Metabolic and weight
Measurements
Body weight
93.8 kg
after one year
Body weight
153 kg
baseline
Source sentences
Summary
Over a follow-up of one year, his weight dropped to 93.8 kg
2 context sentences(design, population, supporting numbers)
Summary · context
We report a 48-year-old man with chronic low back pain and morbid obesity (153 kg) who presented with extensive SEL and critical stenosis.
Summary · context
A non-surgical strategy using GLP-1-induced weight loss (semaglutide) and medical cannabis for pain control was initiated.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-4169443601
02HumanNot a test of Semaglutide aloneCase report or seriesEfficacy outcome
In a man with spinal epidural lipomatosis, pain improved majorly over one year on a regimen of semaglutide with medical cannabis.
In plain wordsIn one man with back pain, pain improved a lot over one year on a regimen of semaglutide and medical cannabis.
Peptide
Semaglutide
Outcome
DecreasePain
Study
n = 1
Outcome group
Pain · Musculoskeletal
Source sentences
Summary
with major improvement in pain and mobility
2 context sentences(design, population, supporting numbers)
Summary · context
We report a 48-year-old man with chronic low back pain and morbid obesity (153 kg) who presented with extensive SEL and critical stenosis.
Summary · context
A non-surgical strategy using GLP-1-induced weight loss (semaglutide) and medical cannabis for pain control was initiated.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-4169443602
03HumanNot a test of Semaglutide aloneCase report or seriesEfficacy outcome
In a man with spinal epidural lipomatosis, mobility improved majorly over one year on a regimen of semaglutide with medical cannabis.
In plain wordsIn one man with back pain, movement improved a lot over one year on a regimen of semaglutide and medical cannabis.
Peptide
Semaglutide
Outcome
IncreaseMobility
Study
n = 1
Outcome group
Exercise and physical function · Musculoskeletal
Source sentences
Summary
with major improvement in pain and mobility
2 context sentences(design, population, supporting numbers)
Summary · context
We report a 48-year-old man with chronic low back pain and morbid obesity (153 kg) who presented with extensive SEL and critical stenosis.
Summary · context
A non-surgical strategy using GLP-1-induced weight loss (semaglutide) and medical cannabis for pain control was initiated.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-4169443603
04HumanNot a test of Semaglutide aloneCase report or seriesEfficacy outcome
In a man with spinal epidural lipomatosis, MRI showed near-complete regression of epidural fat after a regimen of semaglutide with medical cannabis.
In plain wordsIn one man, scans showed nearly all the fat around the spinal cord was gone after a regimen of semaglutide and medical cannabis.
Peptide
Semaglutide
Outcome
DecreaseEpidural fat on MRI
Study
n = 1
Outcome group
Body composition · Musculoskeletal
Source sentences
Summary
MRI demonstrated near-complete regression of epidural fat and resolution of stenosis, avoiding surgery.
2 context sentences(design, population, supporting numbers)
Summary · context
We report a 48-year-old man with chronic low back pain and morbid obesity (153 kg) who presented with extensive SEL and critical stenosis.
Summary · context
A non-surgical strategy using GLP-1-induced weight loss (semaglutide) and medical cannabis for pain control was initiated.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-4169443604
05HumanNot a test of Semaglutide aloneCase report or seriesEfficacy outcome
In a man with critical lumbar stenosis, MRI showed resolution of stenosis, avoiding surgery, after a regimen of semaglutide with medical cannabis.
In plain wordsIn one man, the narrowing of the spinal canal resolved on scans after a regimen of semaglutide and medical cannabis, and surgery was avoided.
Peptide
Semaglutide
Outcome
DecreaseSpinal canal stenosis on MRI
Study
n = 1
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
MRI demonstrated near-complete regression of epidural fat and resolution of stenosis, avoiding surgery.
2 context sentences(design, population, supporting numbers)
Summary · context
We report a 48-year-old man with chronic low back pain and morbid obesity (153 kg) who presented with extensive SEL and critical stenosis.
Summary · context
A non-surgical strategy using GLP-1-induced weight loss (semaglutide) and medical cannabis for pain control was initiated.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-4169443605
06HumanNot a test of Semaglutide aloneCase report or seriesSafety outcome
The man treated with a regimen of semaglutide and medical cannabis remained neurologically intact.
In plain wordsOne man treated with semaglutide and medical cannabis stayed neurologically intact.
Peptide
Semaglutide
Outcome
No significant changeNeurological status
Study
n = 1
Outcome group
Adverse events · Nervous system and cognition
Source sentences
Summary
The patient remained neurologically intact.
2 context sentences(design, population, supporting numbers)
Summary · context
We report a 48-year-old man with chronic low back pain and morbid obesity (153 kg) who presented with extensive SEL and critical stenosis.
Summary · context
A non-surgical strategy using GLP-1-induced weight loss (semaglutide) and medical cannabis for pain control was initiated.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-4169443606

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
11 Oct 2026, 00:04 UTC
Study results updated
Version 1
9 Oct 2026, 03:06 UTC
First added · source update from Europe PMC

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