Impact of cage position in posterior lumbar interbody fusion on cage subsidence in patients with asymmetric Modic changes and analysis of related risk factors

Cage position does not significantly affect subsidence in PLIF for AMC patients, with PLIF effectively alleviating symptoms. Higher Modic grades correlated with reduced subsidence. BMI and blood loss are independent predictors. Early subsidence > 12.5% at 3 months predicts significant risk (≥ 25%) at 1 year, underscoring the necessity of early radiographic surveillance for timely intervention.