Erector Spinae Plane Block vs Transforaminal Epidural Injection

Erector Spinae Plane Block Versus Transforaminal Epidural Injection in Chronic Discogenic Low Back Pain

Lumbar disc herniation is the main cause of low back pain and radicular leg pain. Steroids administered to the epidural area reduce the inflammatory response and pain by inhibiting the synthesis of proinflammatory agents. Epidural steroid injections are used in the treatment of lumbosacral radicular pain with various techniques including fluoroscopy-guided transforaminal and interlaminar injection.

Ultrasound-guided erector spina plan block (ESPB) was first described in 2016 and has been used for postoperative analgesia in many surgeries including thoracic and lumbar dermatomes. The distribution of local anesthesia in the ESPB from the paravertebral area to the transforaminal and epidural space has been shown in studies.

The aim of this study was to compare the efficacy of ultrasound-guided ESPB and fluoroscopic guided transforaminal epidural steroid injection in chronic discogenic low back pain.

Inclusion Criteria:

• American Society of Anesthesiologist's physiologic state I-III patients
• Patients with unilateral radicular pain and low back pain persisting despite medical treatment.

Exclusion Criteria:

• Spinal cord disease or spinal mechanical instability,
• Previous low back surgery,
• More than two levels of lumbar disc hernia,
• Allergic to local anesthetic drugs to be used,
• Use of oral anticoagulants,
• Uncontrolled diabetes mellitus type I and II