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Fluoroscopy-Guided Erector Spinae Plane Block Reduces Early Postoperative Pain Following Lumbar Fusion: A Randomized
Pedram Jahangiri1, Sadegh Bagherzadeh1, Faramarz Roohollahi1,2
1Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Global Spine Journal
|September 6, 2025
Summary
Fluoroscopy-guided erector spinae plane block (ESPB) effectively reduced early postoperative pain and opioid use in lumbar spine surgery patients. However, its benefits were temporary, with no significant long-term impact on pain or recovery.
Area of Science:
- Anesthesiology
- Neurosurgery
- Pain Management
Background:
- Postoperative pain management after lumbar spine surgery presents a significant clinical challenge.
- Erector spinae plane block (ESPB) is a regional anesthesia technique explored for pain control.
- Fluoroscopy guidance offers an alternative when ultrasound is unavailable for ESPB.
Purpose of the Study:
- To evaluate the efficacy of fluoroscopy-guided ESPB in reducing postoperative pain and opioid consumption after lumbar fusion.
- To assess the impact of ESPB on other postoperative outcomes, including ambulation and hospital stay.
- To determine the short-term and long-term effectiveness of ESPB in this patient population.
Main Methods:
- A double-blind, randomized controlled trial involving 80 patients undergoing posterior lumbar fusion.
- Patients received either fluoroscopy-guided ESPB with ropivacaine, dexamethasone, and saline or a placebo.
- Pain intensity, opioid consumption, and other outcomes were measured at multiple time points up to 6 months.
Main Results:
- The ESPB group showed significantly lower axial pain at 4 and 24 hours postoperatively.
- Opioid consumption was significantly reduced in the ESPB group within the first 48 hours.
- No significant differences were found in radicular pain, patient satisfaction, ambulation, or hospital length of stay.
Conclusions:
- Fluoroscopy-guided ESPB is a safe and effective adjunct for managing early postoperative pain and opioid needs after lumbar fusion.
- The analgesic benefits of ESPB appear to be limited to the early postoperative period.
- ESPB did not demonstrate a significant impact on long-term pain control or functional recovery in this study.
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