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Introduction: For preoperative analgesia during a variety of operations, the erector spinae plane block (ESPB) has grown in popularity. However, its effectiveness in lumbar surgery is still unknown. The purpose of this study was to investigate the potential benefits of ESPB in enhancing analgesic efficacy in elderly individuals following posterior lumbar spine surgery.
Methods: Patients aged 65 years or older who underwent elective posterior lumbar instrumented fusion (with or without decompression) at our institution between January 2019 and June 2022 were included. Demographic data, comorbidities, and results of preoperative screening were retrospectively collected. Propensity score matching (PSM) was performed in a ratio of 1:1 for control and ESPB groups. The primary outcome was opioid consumption at 24 h after surgery. Secondary outcomes was visual analog scale (VAS) pain scores at rest in the first 24 h. Additional secondary outcomes included number of patients requesting rescue analgesia, incidence of nausea and vomiting, time to the first request for analgesia via patient-controlled analgesia, and length of stay.
Results: A total of 382 patients were included, of whom 119 received ESPB. The mean age of the study patients was 70.6 years old, and 254 (66.5%) were male. After PSM, each group comprised 115 patients. Patients in the ESPB group showed a significantly lower opioid consumption at 24 h after surgery. Compared with the control group, VAS pain scores at rest in the first 24 h, number of patient-controlled intravenous analgesia (PCIA) pump compressions, ratio of patients requesting rescue analgesia, incidence of nausea and vomiting, and length of stay were significantly reduced in the ESPB group. There were no significant differences between the two groups regarding safety outcomes.
Conclusions: ESPB reduces short-term opioid consumption while providing safe and effective analgesia in elderly patients undergoing posterior lumbar surgery.
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http://dx.doi.org/10.1007/s40122-023-00527-9 | DOI Listing |
World Neurosurg
September 2025
Department of Orthopaedic Surgery, The University of Tokyo 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan; University of Tokyo Spine Group (UTSG), 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan. Electronic address:
Objective: To identify significant risk factors for incidental durotomy (ID) in initial posterior decompression surgery for lumbar central canal stenosis and to explore whether these risks vary by surgical approach through subgroup analyses.
Methods: This study included patients who underwent single-level posterior decompression surgery for lumbar central canal stenosis with bilateral neurogenic claudication at eight hospitals between April 2017 and May 2023. Patient demographics, comorbidities, and surgical details, including surgeon certification status, were collected.
Neurochirurgie
September 2025
Neurosurgery Department, Pasteur 2 Hospital, University Hospital of Nice, France.
Background: Posterior lumbar fusion (PLF) has become one of the most common spinal surgery procedures. Early symptomatic loosening of the pedicle screw could be a critical complication, leading to pseudarthrosis. However, revision strategies for pedicle screw loosening are still under debate.
View Article and Find Full Text PDFProc Inst Mech Eng H
September 2025
IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
Low back pain is estimated to affect more than 70% of the population. Recently, interspinous posterior devices are gaining attention as a less invasive alternative to the traditional pedicle screw systems. However, since most of these devices are not suitable for the L5-S1 segment, the goals for this study are to design a tailored fixation system for the L5-S1 level and to study its effects on the degenerated spine.
View Article and Find Full Text PDFGlobal Spine J
September 2025
Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
DesignRandomized Controlled Trial.ObjectivePostoperative pain after lumbar spine surgery remains a clinical challenge. Fluoroscopy-guided erector spinae plane block (ESPB) has been proposed as a feasible technique for reducing pain and opioid use, particularly when ultrasound guidance is not available.
View Article and Find Full Text PDFJ Neurosurg Spine
September 2025
22Department of Neurosurgery, Medstar Georgetown University Hospital, Washington, DC.
Objective: Variations exist among surgeons in the treatment of recurrent lumbar disc herniation (LDH), generating major issues in decision-making models. The authors aimed to identify international nuances in surgical treatment patterns, highlight the differences in responses in each country group and different treatment trends across countries, and identify factors that influence surgical decisions.
Methods: An online survey with preformulated answers was submitted to 292 orthopedic surgeons and 223 neurosurgeons from 16 countries regarding 3 clinical vignettes (recurrence without low back pain, recurrence with severe low back pain, and recurrence with 2-level disc disease).