Hasoon Jamal, Mahmood Syed, Nguyen Anvinh, Orhurhu Vwaire
Department of Anesthesiology, Critical Care, and Pain Medicine The University of Texas Health Science Center at Houston.
Department of Physiatry and Pain Medicine University of Pittsburgh Medical Center.
Orthop Rev (Pavia). 2024 Oct 30;16:124769. doi: 10.52965/001c.124769. eCollection 2024.
Chronic low back pain is a prevalent and debilitating condition that often resists traditional management strategies such as physical therapy, pharmacotherapy, and interventional procedures. The erector spinae plane (ESP) block, a relatively new regional anesthesia technique, has shown promise in managing various types of pain, including chronic conditions. This case report details the use of the ESP block in a male patient in his late 60's with chronic low back pain unresponsive to conventional treatments, including acetaminophen, muscle relaxants, gabapentin, epidural steroid injections, diagnostic medial branch blocks, and sacroiliac joint injections. Given the refractory nature of his pain, a right-sided lumbar ESP block was performed under fluoroscopic guidance. This case highlights the potential of the ESP block as an effective treatment for chronic lumbar pain, particularly in patients who have not responded to other interventional modalities. The safety profile of the ESP block, coupled with its efficacy in this case, supports its consideration as a viable option in chronic pain management. Further studies and clinical experience will be essential in defining its role and establishing standardized protocols for its use in chronic pain settings.
慢性下腰痛是一种常见且使人衰弱的病症，常常对物理治疗、药物治疗和介入手术等传统治疗策略产生抵抗。竖脊肌平面（ESP）阻滞是一种相对较新的区域麻醉技术，已显示出在管理包括慢性病症在内的各种类型疼痛方面的前景。本病例报告详细介绍了在一名60多岁男性患者中使用ESP阻滞的情况，该患者患有慢性下腰痛，对包括对乙酰氨基酚、肌肉松弛剂、加巴喷丁、硬膜外类固醇注射、诊断性内侧支阻滞和骶髂关节注射在内的传统治疗均无反应。鉴于其疼痛的难治性，在荧光透视引导下进行了右侧腰部ESP阻滞。本病例突出了ESP阻滞作为慢性腰痛有效治疗方法的潜力，特别是在对其他介入方式无反应的患者中。ESP阻滞的安全性，加上其在本病例中的疗效，支持将其视为慢性疼痛管理中的一种可行选择。进一步的研究和临床经验对于确定其作用以及制定在慢性疼痛环境中使用它的标准化方案至关重要。
