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-?; 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-?, 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.