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Altered B12 handling and reduced clearance in kidney disease, and both cellular release and reduced clearance in liver disease, can raise B12, so supportive renal or hepatic findings make those causes plausible

Abbreviations CT: Combined treatment SS: Single surgery JOA: Japanese Orthopaedic Association LDH: Lumbar disc herniation MIS-TILF: Minimally invasive transforaminal lumbar interbody fusion ODI: Oswestry Disability Index PEID: Percutaneous endoscopic interlaminar discectomy VAS: Visual Analog Scale VB12: Vitamin B12 RCT: Randomized controlled trial POD: Postoperative day TNF-: Tumor necrosis factor alpha IL: Interleukin PGE2: Prostaglandin E 2 CI: Confidence interval References Han J, Tang W, Li G, Ji X, Wu X, Zhu K, et al

Folate is abundant in fresh green feeds, but processing feed rapidly destroys it

The exact treatment plan will be determined on an individual basis