{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:22:57Z","timestamp":1781245377606,"version":"3.54.1"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T00:00:00Z","timestamp":1670803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"crossref","award":["DMR-111-097"],"award-info":[{"award-number":["DMR-111-097"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Percutaneous cervical nucleoplasty (PCN) is a simple, safe, and effective treatment for contained cervical herniated intervertebral disc (CHIVD). However, few studies have compared the actual benefits of PCN against conservative treatment (CT), either clinically or radiographically.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>The present study sought to analyze and to compare the outcomes of symptomatic contained CHIVD treated with PCN or CT.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The present study was designed as a case\u2013control comparative study. Patients who indicated for PCN after a failed CT for more than 6 months were recruited. After the exclusion of some patients who did not meet the selection criteria of the study, we finally enrolled 71 patients treated with PCN. In addition, another 21 patients who indicated for PCN but finally chose to receive CT continuously were also enrolled and categorized as the control group. All patients completed the 6-month follow-up. Pain levels and functional outcomes were evaluated pre- and post-operatively by assessing the visual analog scale (VAS), Oswestry Disability Index (ODI), and Neck Disability Index (NDI). Radiographic images of 72 of 104 intervened segments were collected to measure disc height and other cervical spinal alignments, such as range of motion, C2\u20137 Cobb\u2019s angle, and C2\u20137 sagittal vertical axis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Compared with the CT group, the PCN group showed significantly better outcomes on VAS, ODI, and NDI at the 1-month post-operative follow-up, which continued through at least the 6-month follow-up (<jats:italic>P<\/jats:italic> &lt; 0.01 for VAS and <jats:italic>P<\/jats:italic> &lt; 0.05 for ODI and NDI). The mean disc height significantly decreased, from 6.04 \u00b1 0.85 mm to 5.76 \u00b1 1.02 mm, 3 months after PCN treatment (<jats:italic>P<\/jats:italic> = 0.003). However, the degree of disc height decrease did not correlate with the changes of the substantial VAS improvement.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>To provide therapeutic benefits for symptomatic contained CHIVD patients after an invalid CT for 6 months, PCN seems to be a better option than CT. The reduced disc heights did not alter the clinical outcomes of PCN.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0278883","type":"journal-article","created":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T18:23:35Z","timestamp":1670869415000},"page":"e0278883","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Analysis of the clinical and radiological outcomes of percutaneous cervical nucleoplasty: A case\u2013control study"],"prefix":"10.1371","volume":"17","author":[{"given":"Chien-Hua","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You-Pen","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Ru","family":"Ji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Ying","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeng-Hung","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu-Shan","family":"Jaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0369-0935","authenticated-orcid":true,"given":"Cheng-Di","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,12,12]]},"reference":[{"key":"pone.0278883.ref001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1533-2500.2009.00319.x","article-title":"4. Cervical radicular pain","volume":"10","author":"J Van Zundert","year":"2010","journal-title":"Pain Pract"},{"key":"pone.0278883.ref002","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1097\/00000658-195912000-00013","article-title":"Cervical diskography. A contribution to the etiology and mechanism of neck, shoulder and arm pain","volume":"150","author":"RB Cloward","year":"1959","journal-title":"Ann Surg"},{"key":"pone.0278883.ref003","doi-asserted-by":"crossref","first-page":"E109","DOI":"10.1097\/BRS.0b013e318221b5af","article-title":"Evaluation of treatment effectiveness for the herniated cervical disc: a systematic review","volume":"37","author":"L Gebremariam","year":"2012","journal-title":"Spine (Phila Pa 1976)"},{"key":"pone.0278883.ref004","doi-asserted-by":"crossref","first-page":"540","DOI":"10.2176\/nmc.ra.2014-0403","article-title":"Anterior Cervical Spine Surgery for Degenerative Disease: A Review","volume":"55","author":"T. 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