{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:05:00Z","timestamp":1777658700753,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>A retrospective case-control design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study proposed a novel MRI finding termed the \u201cFlying owl sign\u201d to characterize a specific type of lumbar disc herniation (LDH) and examined the correlation between this image finding and the patient-reported outcomes (PROs) following full-endoscopic lumbar discectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective case-control study was conducted involving LDH patients who underwent full-endoscopic lumbar discectomy in our institution. The propensity score matching method was employed to categorize patients into a \u201cFlying owl sign\u201d group and a control group. Multivariable logistic regression analysis was performed to evaluate the relationship between the \u201cFlying owl sign\u201d and the PROs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 431 patients who underwent full-endoscopic lumbar discectomy between November 2015 and October 2022 in our institution were enrolled. After a mean follow-up of 32.24 \u00b1 8.60 months, 377(87.47%) patients were satisfied (NASS score of 1 or 2). 10.21% (44\/431) patients exhibited \u201cFlying owl sign\u201d, and experienced significantly greater improvements in VAS(\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.022), higher patient satisfaction index (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.016), and a lower incidence of residual low back pain (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.013) than the control group. Propensity score matching produced a final study cohort of 88 patients. The multivariate analysis revealed that \u201cFlying owl sign\u201d was a protective factor for satisfaction (OR = 3.544,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.018).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The presence of \u201cFlying owl sign\u201d reflected a specific LDH type, which was the combination of giant disc herniation and the integrity of the posterior longitudinal ligament. \u201cFlying owl sign\u201d correlated with improved postoperative efficacy and satisfaction in patients with LDH, and may contribute to reducing residual low back pain rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682251383497","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T05:47:45Z","timestamp":1758692865000},"page":"1478-1487","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A Novel \u201cFlying Owl Sign\u201d to Predict Favorable Patient-Reported Outcomes Following Full-Endoscopic Lumbar Discectomy"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4499-2086","authenticated-orcid":false,"given":"Jingming","family":"Wang","sequence":"first","affiliation":[{"name":"960 Hospital of People\u2019s Liberation Army"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiantian","family":"Zhu","sequence":"additional","affiliation":[{"name":"960 Hospital of People\u2019s Liberation Army"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"960 Hospital of People\u2019s Liberation Army"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"He","sequence":"additional","affiliation":[{"name":"Department of Orhtopedic and Joint Rehabilitation, Qingdao Special Servicemen Recuperation Center of PLA Navy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0769-8945","authenticated-orcid":false,"given":"Weimin","family":"Huang","sequence":"additional","affiliation":[{"name":"960 Hospital of People\u2019s Liberation Army"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2017.01.003"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-73366-z"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0000000000000628"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-020-06674-3"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2016.10.011"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-982504"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2015.09.060"},{"key":"e_1_3_3_9_2","first-page":"E601","article-title":"Percutaneous endoscopic lumbar discectomy for lumbar disc herniation with modic changes via a transforaminal approach: a retrospective study","volume":"22","author":"Xu J","year":"2019","unstructured":"Xu J, Li Y, Wang B, et al. Percutaneous endoscopic lumbar discectomy for lumbar disc herniation with modic changes via a transforaminal approach: a retrospective study. Pain Physician. 2019;22:E601-e608.","journal-title":"Pain Physician"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.08.061"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199603150-00017"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.12.021"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.BRS.0000077510.95462.39"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200002150-00014"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195946"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/os.13257"},{"key":"e_1_3_3_17_2","volume-title":"Statpearls. 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