Letter: effects of dexamethasone combined with vitamin B12 on percutaneous endoscopic interlaminar discectomy early outcomes: a randomized controlled trial.

Cheng He et al. evaluated the effect of dexamethasone combined with vitamin B12 on early outcomes following percutaneous endoscopic interlaminar discectomy (PEID). While the study offers valuable insights, we have several constructive suggestions. The lack of a standardized anesthesia protocol (local vs. general anesthesia) may have influenced the results, as patients under local anesthesia were awake during the procedure. Previous studies suggest intraoperative communication and patient awareness can impact pain levels and recovery. To clarify the effect of anesthesia type on recovery, we recommend conducting a subgroup analysis based on the anesthesia method. Although the CT group(combined treatment) showed satisfactory pain control (VAS < 3.3), the observed VAS score between days 1 and 3 may not reflect the actual patient experience. Except for the VAS score for leg pain on the third day after surgery, the net intergroup differences at other time points were less than the minimal clinically important differences recommended in the literature(a change of 10 for the 100 mm pain VAS). Furthermore, the study does not assess patient satisfaction with pain management, making it difficult to determine the clinical importance of the treatment effect.