Ultrasound-guided semispinalis obliquus plane block for posterior upper cervical spine surgery: Technical description...

Posterior upper cervical spine surgeries are associated with significant postoperative pain due to extensive soft tissue and muscular dissection, leading to increased nociception transmitted via multi-segmental dorsal rami innervation. We describe the application of a novel ultrasound-guided cervical paraspinal interfascial plane [semispinalis obliquus plane (SOP)] block as a part of multimodal analgesia in ten patients undergoing occipitocervical or atlantoaxial procedures. All patients achieved adequate analgesia; 3 of 10 required minimal rescue fentanyl within the first 24 h, and no block-related complications were observed. The SOP block is a simple, safe, and potentially effective adjunct for perioperative multimodal analgesia in posterior upper cervical spine surgeries, warranting further evaluation.