C-reactive protein; creatine kinase; discectomy; interleukin-6; myoglobin

MethodsA total of 120 patients undergoing surgery for symptomatic disc herniation at L4-L5 and L5-S1 were enrolled in the study. Patients were operated on using open discectomy (OD), microsurgical discectomy (MD), or microsurgical discectomy with tubular retractor (MD-TUB). Myoglobin (MYO) and creatine kinase (CK) levels were used as indicators of muscle damage, and interleukin-6 (IL-6) and C-reactive protein (CRP) levels were used as indicators of systemic inflammatory response. Sampling and analysis of samples were performed preoperatively and on postoperative days 1, 3, and 7. Levels of postoperative low back pain and radicular pain were recorded on a 10-grade visual analog scale. Statistical evaluation was performed using the analysis of variance test. ResultsMYO concentrations in the MD-TUB group on postoperative day 1 were significantly lower than in the MD and OD groups. CK values on postoperative day 1 were significantly lower in microsurgical techniques (MD and MD-TUB) than in the OD group. The lowest IL-6 levels were found in the MD-TUB group, followed by the MD and OD groups. Differences in the IL-6 levels were significant between the groups on postoperative day 1. On all postoperative days that were monitored, values of CRP in the MD-TUB group were significantly lower compared with the MD and OD groups. Lower values in the MD group versus OD group were not statistically significant.