Document Type
Conference Proceeding
Publication Date
5-2024
Publication Title
Journal of Neurosurgery Spine
Abstract
Background/Introduction: Spinal fusion patients suffer significant acute post-operative pain, potentially leading to chronic pain. Opioids are commonly used for peri-operative pain management despite significant side effects. The thoracolumbar interfascial plane (TLIP) and erector spinae plane (ESP) block, alternative analgesic options with rare side effects, have proven to reduce pain and opioid consumption compared to standard non-block care. This study aimed to determine if a significant difference exists between block groups with multi- and single level laminectomy fusions in post-operative and discharge opioid consumption and length of stay. Materials/Methods: A retrospective review was performed via data query for lumbar laminectomy fusion patients from 1/2019 through 5/2023. Patients > 18 years of age who underwent a laminectomy fusion were included. Patients were excluded if they were < 18 years of age, required revision within one-month post-op, and/or had tumor involvement, trauma, multistage procedures, or prior history of spine surgeries. Data including age, sex, opioid use within 1 year pre-operatively, smoking, alcohol, surgery levels, estimated blood loss (EBL), length of stay, analgesic block, and opioid and NSAID usage post-op through discharge prescriptions were recorded. Results: There was a significant difference in age between level groups (p = 0.033); mean age for all patients was 68.1+ 9.5 years. There was no significant difference between level groups or block groups for sex, smoking status, and alcohol use (p > 0.05). A majority of the study population was female (58.8%, n=275). 42.1% of patients used opioids within 1 year preoperatively without significant differences between level groups (p = 0.061) and block groups (p > 0.05). EBL was found to have a significant difference between level groups (p < 0.001), but not block groups (P >0.05). There was a significant difference between level groups regarding hospital opioid usage (p = 0.02); however no significant difference was found between level groups with NSAID usage or block groups with hospital opioid or NSAID usage (p > 0.05). Discussion/Conclusion: Between multi- and single level laminectomy fusions, there is a significant difference in hospital opioid consumption and EBL, yet no difference in hospital opioid or NSAID consumption between block groups.
Volume
40
Issue
5
First Page
24
Last Page
24
Recommended Citation
Eberhardt L, Zakko P, Childers K, Park D. A comparison of post-operative pain management following lumbar laminectomy fusions utilizing TLIP or intra-operative local anesthesia block. J Neurosurg Spine. 2024 May;40(5):24. doi:10.3171/2024.5.LSRS2024abstracts
DOI
10.3171/2024.5.LSRS2024abstracts
Comments
Lumbar Spine Research Society 17th Annual Scientific Meeting, May 2-3, 2024, Chicago, IL