{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:16:37Z","timestamp":1793297797873,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To quantitively characterize the morphology of cervical disc herniation (CDH) causing cervical spondylotic radiculopathy (CSR) and investigate whether the morphological features of CDH are associated with clinical outcomes in CSR patients treated by posterior percutaneous full\u2010endoscopic cervical discectomy (PPECD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single\u2010center retrospective study. Eighty\u2010seven PPECD\u2010treated patients meeting the inclusion criteria were included between May 2017 and May 2019. Based on preoperative T2\u2010weighted magnetic resonance imaging (MRI), we designed and measured six morphological parameters of CDH for all patients to reflect its relative position to cervical spinal cord and protruding degree: DC\u2010SC distance from the center of disc (DC) and the center of spinal cord (SC); DC\u2010DP distance from the center of cervical disc (DC) to the peak of herniation (DP); internal diameter of the disc; axial length of CDH; central angle of CDH formed by central axes of CDH and spinal cord; the modified index of CDH. We recorded general information, neck disability index (NDI) scores, visual analog scale (VAS) scores of neck and arm of all patients preoperatively and postoperatively at 1\u2010year follow\u2010up. The association of preoperative general variables and morphological parameters with clinical outcomes were explored by utilizing logistic regression and receiver operating characteristic curve (ROC) analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The preoperative neck\u2010VAS, arm\u2010VAS, and NDI were significantly decreased after PPECD and remained at a low value at follow\u2010up. In regards to the morphological parameters of CDH, the mean value of DC\u2010SC distance, DC\u2010DP distance, internal diameter of the disc, axial length of CDH, central angle of CDH, and modified index of CDH were 1.61\u2009\u00b1\u20090.30 cm, 1.66\u2009\u00b1\u20090.32cm, 1.04\u2009\u00b1\u20090.21 cm, 0.63\u2009\u00b1\u20090.19cm, 39.38\u00b0\u2009\u00b1\u200911.94\u00b0, and 0.39\u2009\u00b1\u20090.24, respectively. For patients grouped by difference in the recovery rate of NDI and arm\u2010VAS (excellent improved group, EI; and limited improved group, LI), there were no differences in the age, gender, surgical segments, and morphological parameters, except for the central angle of CDH. According to binary logistic regression analysis, only the preoperative central angle of CDH was significantly associated with postoperative NDI recovery (odds ratio: 0.873; 95% confidence interval: 0.819\u20130.931, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.002). ROC analysis showed the optimal cut\u2010off value of the central angle of CDH for predicting the postoperative improvement of functional outcomes is 33.788\u00b0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Preoperative morphology of CDH is related to the outcomes of CSR patients after PPECD. Patients with a large central angle of CDH (&gt;33.788\u00b0) have more likelihood of ameliorating neurological symptoms of CSR. There is the potential to select the central angle of CDH as a predictor for outcomes of PPECD in treating CSR.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13134","type":"journal-article","created":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T04:53:00Z","timestamp":1636519980000},"page":"2335-2343","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Morphology of Herniated Disc as a Predictor for Outcomes of Posterior Percutaneous Full\u2010endoscopic Cervical Discectomy in Treating Cervical Spondylotic Radiculopathy"],"prefix":"10.1111","volume":"13","author":[{"given":"Yi","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Changzheng Hospital, Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo\u2010ke","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Changzheng Hospital, Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010heng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Changzheng Hospital, Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang\u2010gui","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Changzheng Hospital, Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Changzheng Hospital, Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Changzheng Hospital, Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang\u2010ming","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Changzheng Hospital, Second Military Medical University  Shanghai China"},{"name":"Department of Orthopaedics Tongren Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010jian","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Changzheng Hospital, Second Military Medical University  Shanghai China"},{"name":"Department of Orthopaedics Tongren Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai 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