NONSTEROIDAL ANTI-INFLAMMATORY DRUGS IN NEUROSURGERY: CURRENT PERSPECTIVES ON THE MANAGEMENT OF LOW BACK PAIN

Abstract

Low back pain (LBP) is one of the leading causes of disability worldwide and represents a major public health challenge. Degenerative disorders of the lumbar spine, including intervertebral disc degeneration, facet joint arthropathy, ligamentous hypertrophy, and inflammatory changes in paraspinal structures, are among the most common causes of chronic pain requiring conservative or surgical treatment. Nonsteroidal anti-inflammatory drugs (NSAIDs) remain the cornerstone of pharmacological management because of their analgesic, anti-inflammatory, and antipyretic properties. In neurosurgical practice, NSAIDs are widely used before and after spinal surgery to reduce pain, improve functional recovery, and support early mobilization. However, their use should be balanced against potential gastrointestinal, renal, cardiovascular, and bleeding-related adverse effects. This review summarizes current evidence regarding the mechanisms of action, clinical efficacy, safety profile, perioperative considerations, and role of NSAIDs in the management of patients with low back pain in neurosurgical practice.