A single-centre experience of fluoroscopic-guided erector spinae plane blocks in degenerative lumbar spine surgery

An erector spinae plane (ESP) block is a relatively novel interfasical block technique employed when managing post-operative pain. The utilisation of ESP blocks in lumbar spine surgery remains undetermined, although early published studies do show promising results. This study shows a single-centre's experience in the utility of ESP blocks in degenerative lumbar spine surgery.

Prospective data was collected on two separate patient cohorts, with 48 patients in each. The first cohort was considered the standard of care (SOC) group, where they underwent lumbar spine surgery receiving the current SOC for perioperative pain management. The latter cohort received a pre-operative fluoroscopic-guided ESP block. Additional data including patient demographics, surgical procedure, complications, 24-hour opioid use and length of stay were also collected.

The mean day 0 pain score was 4.2 in the ESP block group, and 6 in the SOC group (p = 0.0016). The mean day 1 pain score was 2.3 in the ESP block group, and 5.13 in the SOC group (p < 0.001). 24-hour opioid consumption was 18.62 in the SOC group and 11.88 in the ESP block group (p = 0.05). Length of stay was shorter in the ESP block group with 1.31 days vs 1.79 days in the SOC group (p < 0.05).

This study has shown a significant improvement in pain scores post-lumbar spine surgery when receiving an ESP block. Moving forward, it is important to further explore the use of ESP blocks to improve the patient experience of surgery, along with reducing the total length of stay in hospital.