Anesth Pain Med.  2022 Jul;17(3):327-330. 10.17085/apm.21107.

Two-level bilateral ultrasound-guided erector spinae plane block for kyphosis corrective surgery - A case report -

• Sinha C
• Kumar A
• Kumar A
• Kumari P
• Agrawal P
• SK A

• KMID: 2535327
• DOI: http://doi.org/10.17085/apm.21107

Abstract

Background
Ultrasound-guided erector spinae plane (ESP) block has been used to provide lumbar analgesia. The craniocaudal spread of local anesthetic in this block can be unpredictable in patients with kyphosis due to backward curvature of the spine, which might prevent longitudinal spread. Case: This is a case of a 33-year-old male (60 kg) diagnosed with type 3b kyphosis of the thoracolumbar region at the level of L1 who underwent extended pedicle subtraction osteotomy. ESP block was administered at two different levels, one at T12 (above the angle of the kyphosis L1) and another at L3 (below the angle of kyphosis L1), as the curvature of kyphosis can hinder the longitudinal spread of local anesthetic. Conclusions: Two-level ESP block results in better craniocaudal spread of local anesthetic in a patient undergoing kyphosis correction surgery.

Keyword

Anesthesia; Nerve block; Spinal; Ultrasonography

Figure

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  Fig. 1. (A) MRI spine with kyphosis (type 3b angle > 60 degree) at thoracolumbar region, (B) transverse approach to ESP block by In-plane technique, (C) sonoanatomy of transverse approach of ESP block. MRI: magnetic resonance imaging, ESP: erector spinae plane, US: ultrasound, LA: local anesthetic.

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