Cervical Erector Spinae Plane Block in a Patient with Failed Neck Surgery Syndrome: A Case Report and Literature Review

TL;DR

A cervical erector spinae plane block provided pain relief for a patient with failed neck surgery syndrome who couldn't undergo other treatments.

Contribution

This case report introduces cervical ESPB as a novel, minimally invasive option for managing FNSS pain.

Findings

Cervical ESPB led to significant pain reduction in a patient with FNSS.

The procedure improved functional outcomes as measured by NRS and NDI scores.

Abstract

Failed neck surgery syndrome (FNSS) following posterior cervical spine fusion (PSF) presents a considerable challenge in pain management.

This study aims to report the potential utility of the cervical erector spinae plane block (ESPB) as an influential adjunctive therapy in a patient with FNSS who was refractory to medical therapy and unable to undergo spinal cord stimulation (SCS) due to financial constraints.

This case report details a 74-year-old male with persistent, debilitating axial neck pain lasting one year following PSF, without neural or motor deficits, and with device failure ruled out. Given the risks of cervical epidural steroid injection in this patient, a fluoroscopically guided bilateral cervical ESPB at the C7 level was administered for temporary pain relief.

This technique was associated with substantial pain relief and improved functional outcomes, as demonstrated by reductions in the Numerical Rating Scale (NRS) and Neck Disability Index (NDI) scores.

This case underscores the potential utility of the cervical ESPB as an effective adjunctive therapy for managing pain in FNSS, providing a minimally invasive alternative to conventional treatment approaches.