ABSTRACT Objective Pedicle screw loosening is one of the common complications in elderly patients undergoing transforaminal lumbar interbody
ABSTRACT Objective Pedicle screw loosening is one of the common complications in elderly patients undergoing transforaminal lumbar interbody fusion (TLIF) for lumbar spine disease. Malnutrition, prevalent among elderly patients, has been shown to be associated with increased complications. The Geriatric Nutritional Risk Index (GNRI) serves as a simple indicator of nutritional status. However, the relationship between malnutrition, particularly GNRI, and pedicle screw loosening has not been adequately investigated. This study aims to investigate the relationship between GNRI and pedicle screw loosening following TLIF to guide the perioperative nutritional management of patients and prevent postoperative complications. Methods A retrospective review was conducted on clinical data from patients who underwent single‐level TLIF between 2014 and 2022. Data collection encompassed patient demographics, preoperative laboratory parameters, surgery‐related data, perioperative radiographic data, and patient‐reported outcomes were comprehensively documented. All patients were followed up for a minimum of 12 months. The relationship between GNRI and pedicle screw loosening was evaluated by univariate and multivariate Cox regression analysis, restricted cubic spline (RCS) analysis, receiver operating characteristic (ROC) analysis, and Kaplan–Meier survival analysis. Results A total of 426 patients were included in the study. The rate of pedicle screw loosening rate was 16.4% at a minimum follow‐up of 12 months. Patients with pedicle screw loosening exhibited significantly lower GNRI (89.0 ± 8.0 vs. 99.2 ± 9.3, p
