Comparative analysis of percutaneous endoscopic lumbar discectomy and microdiscectomy: Outcomes in lumbar disc herniation treatment with post-operative use of analgesics and NSAIDs.

BACKGROUND

Percutaneous endoscopic lumbar discectomy (PELD) and microdiscectomy (MD) are both minimally invasive for lumbar disc herniation (LDH); the differential efficacy of analgesics and NSAIDs after these two surgeries requires further clarification.

OBJECTIVE

This study aimed to compare and evaluate the efficacy of analgesics and NSAIDs after PELD and MD.

METHODS

A retrospective study (Jan 2022-Jun 2024) enrolled 232 LDH patients; 211 were retained after screening and divided into Group A (PELD, n=109) and Group B (MD, n=102). Primary indicators included VAS, ODI and inflammatory factors IL-6, IL-8, TNF-α; secondary indicators included hospital stay, LANSS score, modified MacNab criteria evaluation and postoperative complications.

RESULTS

At 2 weeks postoperatively, Group A had significantly lower VAS, ODI, IL-6, TNF-α, IL-8 and LANSS scores (P=0.035; 0.008; 0.01; 0.038; 0.017; 0.021), while no significant differences were observed at 3 months and 1 year postoperatively between the two groups (all P>0.05). Shorter hospital stays and fewer wound complications in Group A (P=0.023; 0.04). One year postoperatively, no significant differences were observed in the modified MacNab excellent-good rate or the incidence of postoperative complications between the two groups (all P>0.05).

CONCLUSION

Pregabalin and celecoxib administered after PELD/MD were effective and safe for LDH patients. PELD achieved better short-term outcomes, with no significant difference during 1-year follow-up.