Erector Spinae Plane Blocks for Circumferential Lumbar Spinal Fusion: Retrospective Cohort Study

Area of Science:

• Anesthesiology
• Neurosurgery
• Orthopedic Surgery

Background:

• Circumferential lumbar fusions present significant postoperative pain management challenges.
• Opioid-sparing analgesia is crucial for these extensive procedures.
• Erector spinae plane (ESP) blocks show promise for pain control in thoracolumbar surgery.

Purpose of the Study:

• To evaluate the efficacy of ESP blocks for postoperative pain control.
• To assess the impact of ESP blocks on opioid consumption in circumferential lumbar spinal fusion patients.

Main Methods:

• Retrospective review of patients undergoing 1- or 2-level elective anterior lumbar interbody fusion with posterior decompression and fusion.
• Analysis of ESP block effects on hospital length of stay (LOS), visual analog scale (VAS) pain scores, and opioid consumption (morphine milligram equivalents).

Main Results:

• Patients receiving preoperative ESP blocks had a significantly shorter LOS (3.0 vs 4.0 days, P=0.005).
• ESP block recipients showed lower cumulative opioid consumption in the first 48 hours (123.7 vs 141.2 MME, P=0.05).
• VAS scores did not significantly differ except on postoperative day 4 and at 12-month follow-up.

Conclusions:

• ESP blocks are associated with reduced postoperative opioid requirements and LOS in patients undergoing circumferential lumbar fusion.
• This study supports ESP blocks as a valuable component of multimodal pain management strategies.
• Clinical evidence supports the use of ESP blocks for circumferential lumbar spine fusion procedures.