Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD

Current Issue - March 2023 - Vol 7 Issue 2 Index  |  Previous  |  Next



  1. 2023;7;77-81 Motor Blockade After Erector Spinae Plane Block for Lumbar Spinal Surgery: A Case Report
    Case Report
    Dylan Shearer, MD, Reed W. Kamyszek, MD, Trishul Kapoor, MD, Jay Saggu, MD, DMD, Grace Li, MD, and Srinivas Chiravuri, MD.

BACKGROUND: Regional anesthetic techniques, including the erector spinae plane block (ESPB), decrease pain scores while reducing opioid consumption. Given their high safety profile and analgesic efficacy, ESPBs offer an alternative to neuraxial anesthetic techniques for perioperative analgesia.

CASE REPORT: Transient unilateral dense L3 motor weakness occurred as a complication of the ESPB performed intraoperatively for an L2-L5 laminectomy and L2-L3 discectomy at the L3 level. The motor weakness was concerning for spinal cord injury and confounded the postoperative neurologic examination.

CONCLUSIONS: Lesson learnt from this case suggests the lumbar ESPB should be performed preoperatively in awake patients to avoid confounding physical exam findings in the postoperative anesthesia care unit; this also reduces the need for further emergent imaging and workup. During a lumbar ESPB, a local anesthetic should be deposited at the tip of the transverse process, and not breach the intertransversarii muscle and ligament to favor the dorsal spread and sparing of ventral rami motor fibers.

KEY WORDS: Erector spinae plane block, ultrasound, regional anesthesia, spine surgery