Objective:

To identify risk factors associated with cage migration (CM) after posterior lumbar interbody fusion (PLIF) and develop a predictive nomogram to enhance surgical outcomes.

Key Findings:

• The overall prevalence of CM was 8.9%.
• Independent risk factors for CM included osteoporosis (OR = 4.186), spondylolisthesis (OR = 8.199), Modic type I change (OR = 8.279), PI-LL mismatch (OR = 1.306), and preoperative hemoglobin levels (OR = 0.822).
• The nomogram demonstrated strong discrimination (AUC=0.874) and good calibration.

Interpretation:

The nomogram can assist healthcare professionals in preoperative risk assessment and tailored surgical planning for patients undergoing PLIF.

Limitations:

• The study was retrospective and conducted at a single institution, which may limit generalizability and introduce biases in data collection and patient selection.

Conclusion:

The developed nomogram provides a valuable tool for predicting CM risk, potentially improving surgical outcomes in PLIF procedures and aiding in tailored surgical planning.