Changes in serum pain mediators, stress response, inflammatory markers, and coagulation function in lumbar disc herniation patients treated by musculoskeletal ultrasound-guided needle-knife.

BACKGROUND

To investigate the impacts of musculoskeletal ultrasound (MSK-US)-guided needle-knife on serum pain mediators, stress response, inflammatory markers, and coagulation function in lumbar disc herniation (LDH) patients.

METHODS

In this prospective cohort study, we recruited 100 LDH patients admitted between February 2024 and January 2025 and assigned them to an MSK-US group (52 cases undergoing MSK-US-guided needle-knife) and a conventional group (48 cases receiving conventional needle-knife). Peripheral venous blood was collected before and within 2 hours postoperatively for IL-6, TNF-a, SP 5-HT, and hs-CRP measurements by ELISA, Cor, E, and NE determination using an automatic biochemical analyzer, b-EP detection by chemiluminescent immunoassay, and APTT, PT, FIB, and D-D quantification with a coagulation analyzer. Dynamic changes in these biomarkers were analyzed by betweenand within-group comparisons.

RESULTS

Both groups demonstrated postoperative reductions in SP and 5-HT and an elevation in b-EP (P< 0.05), though no marked inter-group differences were noted (P> 0.05). The MSK-US group showed lower postoperative levels of Cor, E, NE, IL-6, hs-CRP D-D, and FIB than the conventional group (P< 0.05), suggesting MSK-US's ability to reduce inflammation, alleviate stress reaction, and lower hyperfibrinolysis risk.

CONCLUSIONS

MSK-US-guided needle-knife is effective in mitigating perioperative stress response and systemic inflammation in LDH patients while reducing the risk of coagulation disorders and providing a biomarker-driven framework for personalized postoperative management.