16. 竖脊肌平面阻滞对MIS-TLIF术后慢性疼痛的长期影响：一项回顾性研究

IF 2.5 Q3 Medicine

North American Spine Society Journal Pub Date : 2025-07-01 DOI:10.1016/j.xnsj.2025.100710

Ling-Ya Chen MD , Lin Jia-Yi MD , JiannHer Lin MD

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引用次数: 0

摘要

背景：慢性术后疼痛（CPSP）是腰椎手术后的一个重要问题，通常与围手术期疼痛控制不足有关。目前的策略仍然不令人满意，增加了术后腰痛的风险。竖脊平面阻滞（ESPB）已显示出早期疼痛管理的希望，但其对CPSP的长期影响尚不清楚。目的探讨ESPB在术后早期疼痛控制中的作用及其对CPSP发展的影响。研究设计/设置：回顾性队列研究。患者样本：行MIS-TLIF的退行性腰椎疾病患者。收集短期结果（住院时间、吗啡当量剂量）和长期结果（术后1年疼痛VAS、ODI、PCS）。方法scpsp定义为术后1年VAS评分3分。分析前使用倾向评分匹配来平衡各组之间的基线差异。结果接受ESPB治疗的患者共46例，对照组175例。在短期结果中，ESPB组吗啡当量剂量显著降低(平均28.13 mg vs 41.83 mg, p<；.01)和停留时间(平均2.45天vs 4.03天，p<；措施)。对于长期结果，ESPB组显示背部CPSP发生率显著降低(OR 0.15, 95% CI 0.02-1.16, p<；0.05)和leg (OR 0.10, 95% CI 0.01-0.80, p<；. 01)。然而，术后1年疼痛VAS、ODI和PCS评分无显著差异。结论：sespb与MIS-TLIF术后CPSP发生率降低相关，提示围手术期疼痛控制的改善可能提供长期益处。FDA器械/药物状态本摘要不讨论或包括任何适用的器械或药物。

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16. Long-term Impact of Erector Spinae Plane Block on Chronic Postsurgical Pain after MIS-TLIF: A Retrospective Study

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.