{"title":"16. Long-term Impact of Erector Spinae Plane Block on Chronic Postsurgical Pain after MIS-TLIF: A Retrospective Study","authors":"Ling-Ya Chen MD , Lin Jia-Yi MD , JiannHer Lin MD","doi":"10.1016/j.xnsj.2025.100710","DOIUrl":null,"url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Chronic postsurgical pain (CPSP) is a significant issue following lumbar surgery, often linked to inadequate perioperative pain control. Current strategies remain unsatisfactory, increasing the risk of postsurgical low back pain. The erector spinae plane block (ESPB) has shown promise for early pain management, but its long-term effects on CPSP remain unclear.</div></div><div><h3>PURPOSE</h3><div>This study aims to investigate the efficacy of ESPB in early postoperative pain control and its impact on the development of CPSP.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Retrospective cohort study.</div></div><div><h3>PATIENT SAMPLE</h3><div>Patients with degenerative lumbar disorders who underwent MIS-TLIF.</div></div><div><h3>OUTCOME MEASURES</h3><div>Short-term outcomes (length of stay, morphine equivalent dose) and long-term measures (1-year postoperative Sng-Pain VAS, ODI, PCS) were collected.</div></div><div><h3>METHODS</h3><div>CPSP was defined as a VAS score >3 one year after surgery. Propensity score matching was applied to balance baseline differences between groups before analysis.</div></div><div><h3>RESULTS</h3><div>A total of 46 patients receiving ESPB were compared to 175 patients in the control group. In short-term outcomes, the ESPB group had significantly lower Morphine Equivalent Dose (mean 28.13 mg vs 41.83 mg, p< .01) and length of stay (mean 2.45 days vs 4.03 days, p< .001). For long-term outcomes, the ESPB group showed a significantly reduced incidence of CPSP in the back (OR 0.15, 95% CI 0.02-1.16, p< .05) and leg (OR 0.10, 95% CI 0.01-0.80, p< .01). However, there were no significant differences in 1-year postoperative Sng (soreness) VAS, ODI, and PCS scores.</div></div><div><h3>CONCLUSIONS</h3><div>ESPB is associated with a reduced incidence of CPSP after MIS-TLIF surgery, suggesting that improved perioperative pain control may provide long-term benefits.</div></div><div><h3>FDA Device/Drug Status</h3><div>This abstract does not discuss or include any applicable devices or drugs.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100710"},"PeriodicalIF":2.5000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"North American Spine Society Journal","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666548425001301","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
BACKGROUND CONTEXT
Chronic postsurgical pain (CPSP) is a significant issue following lumbar surgery, often linked to inadequate perioperative pain control. Current strategies remain unsatisfactory, increasing the risk of postsurgical low back pain. The erector spinae plane block (ESPB) has shown promise for early pain management, but its long-term effects on CPSP remain unclear.
PURPOSE
This study aims to investigate the efficacy of ESPB in early postoperative pain control and its impact on the development of CPSP.
STUDY DESIGN/SETTING
Retrospective cohort study.
PATIENT SAMPLE
Patients with degenerative lumbar disorders who underwent MIS-TLIF.
OUTCOME MEASURES
Short-term outcomes (length of stay, morphine equivalent dose) and long-term measures (1-year postoperative Sng-Pain VAS, ODI, PCS) were collected.
METHODS
CPSP was defined as a VAS score >3 one year after surgery. Propensity score matching was applied to balance baseline differences between groups before analysis.
RESULTS
A total of 46 patients receiving ESPB were compared to 175 patients in the control group. In short-term outcomes, the ESPB group had significantly lower Morphine Equivalent Dose (mean 28.13 mg vs 41.83 mg, p< .01) and length of stay (mean 2.45 days vs 4.03 days, p< .001). For long-term outcomes, the ESPB group showed a significantly reduced incidence of CPSP in the back (OR 0.15, 95% CI 0.02-1.16, p< .05) and leg (OR 0.10, 95% CI 0.01-0.80, p< .01). However, there were no significant differences in 1-year postoperative Sng (soreness) VAS, ODI, and PCS scores.
CONCLUSIONS
ESPB is associated with a reduced incidence of CPSP after MIS-TLIF surgery, suggesting that improved perioperative pain control may provide long-term benefits.
FDA Device/Drug Status
This abstract does not discuss or include any applicable devices or drugs.