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

## TL;DR

This study examines how using ultrasound-guided needle-knife surgery affects pain, stress, inflammation, and blood clotting in patients with lumbar disc herniation.

## Contribution

The study introduces a biomarker-driven framework for personalized postoperative management using MSK-US-guided needle-knife.

## Key findings

- MSK-US-guided needle-knife reduced stress markers and inflammation compared to conventional methods.
- Both groups showed reduced pain mediators post-surgery, but MSK-US had lower coagulation risks.
- MSK-US-guided surgery lowers the risk of hyperfibrinolysis and systemic inflammation.

## Abstract

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.

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.

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.

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.