Braxton Ernest E, Brena Kyle R, Spears Holley, Conrad Emerson, Heinze Jared D
1Department of Orthopaedics and Neurosurgery, Vail-Summit Orthopaedics and Neurosurgery, Vail, Colorado.
2Vail-Summit Orthopaedics and Neurosurgery Research and Education Foundation, Vail-Summit Orthopaedics and Neurosurgery, Vail, Colorado; and.
J Neurosurg Case Lessons. 2022 May 2;3(18). doi: 10.3171/CASE21633.
Postoperative pain management is a limiting factor for early ambulation and discharge following spine fusion surgery. Awake spinal surgery, when combined with minimally invasive transforaminal lumbar interbody fusion, is associated with enhanced recovery in well-selected patients. Some neurosurgeons have recently aimed to further improve outcomes by utilizing erector spinae plane block catheters, allowing for a continuous infusion of local anesthetic to improve the management of acute postoperative pain following minimally invasive transforaminal lumbar interbody fusion.
A patient who underwent a minimally invasive transforaminal lumbar interbody fusion with perioperatively placed erector spinae plane catheters at the T12 level ambulated 30 minutes after surgery and was discharged the same day (length of stay, 4.6 hours). The total amount of narcotics administered during the hospital stay was 127.5 morphine milligram equivalents.
The placement of bilateral erector spine plane nerve block catheters at the T12 level with an ambulatory infusion pump may help to improve acute postoperative pain management for patients undergoing lumbar spinal fusion.
术后疼痛管理是脊柱融合手术后早期活动和出院的限制因素。清醒脊柱手术与微创经椎间孔腰椎椎间融合术相结合，在精心挑选的患者中与恢复加快相关。一些神经外科医生最近旨在通过使用竖脊肌平面阻滞导管进一步改善治疗效果，以便持续输注局部麻醉剂，从而改善微创经椎间孔腰椎椎间融合术后急性疼痛的管理。
一名患者接受了微创经椎间孔腰椎椎间融合术，术中在T12水平放置了围手术期竖脊肌平面导管，术后30分钟即可行走，并于同日出院（住院时间为4.6小时）。住院期间给予的麻醉剂总量为127.5毫克吗啡当量。
在T12水平放置双侧竖脊肌平面神经阻滞导管并配备可移动输注泵，可能有助于改善腰椎融合手术患者术后急性疼痛的管理。
