Effect of Monopolar Electrocautery and Blunt Dissection on Muscle Damage and Inflammation in Patients Undergoing Lumbar Microdiscectomy.

BACKGROUND This study compares the effects of monopolar electrocautery and blunt dissection on muscle damage, inflammatory response, and bleeding control in lumbar microdiscectomy surgery. This retrospective study aimed to compare the outcomes of muscle damage (creatine kinase (CK), lactate dehydrogenase levels (LDH)), inflammation (C-reactive protein levels [CRP]), and intraoperative bleeding (hemoglobin). MATERIAL AND METHODS Seventy-two patients (36 in each group) who underwent single-level lumbar microdiscectomy between 2021 and 2023 were retrospectively analyzed. In group A, the fascia and multifidus muscle were opened with electrocautery, and in group B, the fascia was opened with scalpel/Matzenbaum, and blunt dissection was performed with a periosteal elevator. CK, LDH, CRP, and hemoglobin levels were measured preoperatively and at 1 and 24 h. Statistical analyses used t test, Mann-Whitney U test, and repeated measures ANOVA. RESULTS CK levels at 24 h were significantly higher in group B (P<0.05). CRP levels at 1 h were significantly higher in group A (P=0.003). Hemoglobin decrease was greater in group B. There was no significant difference in LDH levels. CONCLUSIONS In our study, monopolar electrocautery was associated with less muscle damage, while a more pronounced inflammatory response was observed. Electrocautery provided better intraoperative bleeding control.