COMPARATIVE EFFECTS OF ERECTOR SPINAE PLANE BLOCK AND FACET JOINT MEDIAL BRANCH BLOCK ON PAIN AND FUNCTIONAL DISABILITY IN PATIENTS WITH FACET-MEDIATED SPINAL PAIN

Abstract

Background: Facet mediated spinal pain can cause significant pain and disability in the cervical and lumbar spine. Facet joint medial branch blocks (MBB) are established treatments for this pain. Erector Spinae Plane Blocks (ESPB) are more recent treatments for facet mediated pain, and provide more extensive local anesthesia due to their interfascial location.

Objective: To compare the effects of MBB and ESPB on pain and the disability of patients with facet mediated spinal pain.

Methods: In this randomized clinical study, 44 participants were randomly allocated to undergo either single ultrasound guided posterior cervical plexus block (ESPB; n = 22) or single fluoroscopically guided cervical median branch block (MBB; n = 22). Pain and functional disability of the neck and back were assessed. Pain was measured using Numeric Pain Rating Scale (NPRS) and functional disability was measured using Oswestry Disability Index (ODI) and Neck Disability Index (NDI). Assessments were performed at the time of block and 4 weeks and 12 weeks after block.

Results: Baseline demographic and clinical characteristics and outcome scores were comparable between groups. Both groups improved significantly over time. At 4 weeks, MBB produced lower NPRS (3.55±0.86 vs 4.82±0.96; p<0.001), ODI (30.09±5.97% vs 36.73±6.25%; p=0.001), and NDI (27.73±4.24% vs 35.73±4.06%; p<0.001) than ESPB. At 12 weeks, the MBB group again had lower NPRS (2.23±0.69 vs 3.59±1.05; p<0.001), ODI (19.00±6.01% vs 26.82±5.19%; p<0.001), and NDI (17.73±4.24% vs 25.73±4.06%; p<0.001). Both MBB and ESPB groups demonstrated clinically relevant improvements in pain and disability at 12 weeks. The MBB group, however, demonstrated greater improvements at both time points compared to the ESPB group.