{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:11:59Z","timestamp":1778825519499,"version":"3.51.4"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Posterior lumbar interbody fusion (PLIF) is widely used for lumbar diseases, but cage migration (CM) remains a frequent and serious complication. Identifying risk factors for CM is crucial to improving surgical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was conducted on 517 patients who underwent PLIF surgery at Nanyang Central Hospital between January 2020 and December 2024. Patients were divided into CM (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200946) and non-CM groups (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009471) based on postoperative imaging findings. Demographic characteristics, intraoperative parameters, and radiographic data were collected. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of CM. A nomogram model was constructed based on significant variables, and its performance was evaluated using a receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall incidence of CM was 8.9%. Univariate analysis revealed significant differences in the rates of osteoporosis, spondylolisthesis, Modic changes, PI-LL mismatch, and preoperative hemoglobin levels between the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Multivariate analysis identified osteoporosis (OR\u2009=\u20094.186, 95% CI: 1.654\u201311.421), spondylolisthesis (OR\u2009=\u20098.199, 95% CI: 3.191\u201322.937), Modic type I change (OR\u2009=\u20098.279, 95% CI: 3.135\u201323.891), PI-LL (OR\u2009=\u20091.306, 95% CI: 1.192\u20131.453), and preoperative hemoglobin level (OR\u2009=\u20090.822, 95% CI: 0.753\u20130.888) as independent risk factors for CM. A nomogram incorporating these five variables showed good discrimination (AUC=0.874, 95% CI: 0.813\u20130.935) and calibration (Hosmer\u2013Lemeshow test,\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20097.530,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.481). DCA demonstrated a favorable net benefit across a threshold probability range of 0.05 to 0.81.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The developed nomogram model may assist clinicians in preoperative risk stratification and in formulating personalized surgical and perioperative strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1785695","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:43:27Z","timestamp":1778823807000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a predictive nomogram for cage migration after posterior lumbar interbody fusion: a retrospective study of 517 patients"],"prefix":"10.3389","volume":"13","author":[{"given":"Yuan","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, Nanyang Central Hospital","place":["Nanyang, Henan Province, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianji","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Nanyang Central Hospital","place":["Nanyang, Henan Province, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongzhen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuqiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Beijing Tiantan Hospital, Capital Medical University","place":["Beijing, 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