Anesth Pain Med.  2023 Oct;18(4):406-413. 10.17085/apm.23064.

Comparison of pain relief of the cervical radiculopathy between high thoracic erector spinae plane block and cervical epidural injection

• Hong JH
• Huh SN

• KMID: 2550921
• DOI: http://doi.org/10.17085/apm.23064

Abstract

Background
The high thoracic erector spinae plane block (ESPB) has been used for the management of chronic shoulder pain or arthroscopic shoulder surgery. No study has evaluated the analgesic efficacy of ESPB in patients with cervical radiculopathy although it is a favored and easy technique compared to neuraxial block. The purpose of this study was to compare the treatment outcome of cervical radiculopathy using high thoracic ESPB or cervical interlaminar epidural injection (CEPI). Methods: This study included 82 patients with neck and arm pain who received CEPI (CEPI group) using 4 ml of 0.1% ropivacaine or high thoracic ipsilateral ESPB (ESPB group) at the T2 or T3 level using 20 ml of 0.1% ropivacaine 20 ml. The degree of pain relief and disability were assessed using an 11-point numerical scale (NRS) and neck disability index (NDI), respectively. Results: The CEPI and ESPB groups demonstrated an equal number of patients with excellent pain relief (NRS reduction ≥ 50%). Significant reduction of NRS was found in both groups, and the effect of time was statistically significant in the groups (P < 0.001). The number of patients who showed an excellent improvement in NDI (NDI reduction ≥ 30%) was 20 (48.8%) and 22 (53.7%) in the CEPI and ESPB groups, respectively. Conclusions: Both the CEPI and ESPB demonstrated significant relief in neck and arm pain with improvement in disability.

Keyword

Analgesic efficacy; Cervical interlaminar epidural injection; Erector spinae plane block; Neck and arm pain; Neck disability index; Numerical rating scale

Figure

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  Fig. 1. Consort diagram. ESPB: erector spinae plane block, CEPI: cervical interlaminar epidural injection.

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  Fig. 2. Comparison of changes in the 11-point NRS before ESPB or CEPI, and at 30 min, 1 week, 2 weeks, 4 weeks, and 8 weeks after ESPB or CEPI. A higher score indicates a greater degree of pain. NRS: numerical rating scale, ESPB: erector spinae plane block, CEPI: cervical interlaminar epidural injection, CI: confidence interval.

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  Fig. 3. Comparison of changes in the NDI before ESPB or CEPI and 8 weeks after ESPB or CEPI. A higher score indicates a greater degree of disability. NDI: neck disability index, ESPB: erector spinae plane block, CEPI: cervical interlaminar epidural injection, CI: confidence interval.

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