腰方肌平面阻滞：尸体研究。
The lumbar erector spinae plane block: a cadaveric study.
机构信息
Division of Pain Management, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, İstanbul UniversityCerrahpasa, İstanbul, Turkey.
Department of Anatomy, Faculty of Medicine, İstanbul University-Cerrahpasa, İstanbul, Turkey.
出版信息
Turk J Med Sci. 2022 Feb;52(1):229-236. doi: 10.3906/sag-2107-83. Epub 2022 Feb 22.
BACKGROUND
The aim of this cadaveric study was to investigate the erector spinae plane block (ESPB) in lumbar region and to elucidate the possible mechanisms of action of these injections in lumbar radicular pain by means of detecting expected dye dispersion to the neural structures.
METHODS
Ultrasound-guided lumbar ESPB was performed in three formaldehyde-embalmed human cadavers. For this purpose, a 10 mL of methylene blue was injected into the fascial space between the L4 transverse process and the erector spinae muscles. T hen, the cadavers were dissected, the cephalocaudal and lateral spread of the dye was examined, and the involvement of the dorsal rami, dorsal root ganglia and ventral rami were analyzed. The distribution into the epidural space was also evaluated.
RESULTS
The involvement of the dorsal rami was found to extend up to the T12 level and down to the L5 spinal nerves. Although dye dispersion was detected on the dorsal root ganglion in all specimens, it was found to be limited to one or two levels, unlike the dorsal rami. In half of the specimens, distribution to the ventral ramus and posterior epidural space was observed.
背景
本尸体研究旨在探讨腰部竖脊肌平面阻滞（ESPB），并通过检测预期的染料向神经结构的分散来阐明这些注射治疗腰椎神经根痛的可能作用机制。
方法
在 3 具福尔马林固定的人体尸体上进行超声引导下的腰椎 ESPB。为此，在 L4 横突和竖脊肌之间的筋膜间隙内注射 10 毫升亚甲蓝。然后，对尸体进行解剖，检查染料的头侧尾侧和侧方扩散，并分析背支、背根神经节和腹支的受累情况。还评估了向硬膜外间隙的分布。
结果
发现背支的受累范围可延伸至 T12 水平以下至 L5 脊神经。尽管所有标本均发现染料在背根神经节上有扩散，但与背支不同，这种扩散仅限于一个或两个水平。在一半的标本中，观察到向腹支和后硬膜外间隙的分布。
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