Intraoperative Intercostal Nerve Block for Pain Management After Retropleural Thoracic Discectomy: Anatomy and Technique

Authors

• Juan P. Giraldo, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
• Gabriella P. Williams, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
• James J. Zhou, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
• Nafis B. Eghrari, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA; Case Western Reserve University School of Medicine, Health Education Campus, Cleveland, Ohio, USA.
• Teresa Kalantari, Department of Neurosurgery, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain.
• Joseph M. Abbatematteo, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
• Jonathan J. Lee, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
• S Harrison Farber, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
• Luke K. O'Neill, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
• Juan S. Uribe, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA. Electronic address: Neuropub@barrowneuro.org.

Document Type

Article

Abstract

BACKGROUND: Thoracic discectomy procedures require early and adequate pain control to alleviate patient discomfort after surgery. The intraoperative placement of a nerve block after intercostal nerve violation can offer early pain management after thoracic discectomy. METHODS: The anatomy and technique of placing an intercostal nerve block after retropleural thoracic discectomy are described. Patient data were collected for patients who underwent this technique. RESULTS: This approach is presented with an illustrative figure and a review of relevant anatomical landmarks to describe the technique and ensure its reproducibility. Data for 93 patients (57 [61%] women; 36 [39%] men; mean [SD] age, 54.1 [14.1] years) who underwent the procedure are provided to assess the reliability of this technique. CONCLUSIONS: Intercostal nerve blockage offers a valuable addition to postoperative pain management and may be considered as an available pain relief option for patients undergoing thoracic discectomy.

Medical Subject Headings

Humans; Nerve Block (methods); Intercostal Nerves (anatomy & histology); Male; Female; Middle Aged; Diskectomy (methods); Thoracic Vertebrae (surgery); Pain, Postoperative (prevention & control); Adult; Aged; Pain Management (methods)

Publication Date

12-1-2024

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

192

First Page

63

Last Page

67

PubMed ID

39214296

Digital Object Identifier (DOI)

10.1016/j.wneu.2024.08.116

Recommended Citation

Giraldo, Juan P.; Williams, Gabriella P.; Zhou, James J.; Eghrari, Nafis B.; Kalantari, Teresa; Abbatematteo, Joseph M.; Lee, Jonathan J.; Farber, S Harrison; O'Neill, Luke K.; and Uribe, Juan S., "Intraoperative Intercostal Nerve Block for Pain Management After Retropleural Thoracic Discectomy: Anatomy and Technique" (2024). Neurosurgery. 2383.
https://scholar.barrowneuro.org/neurosurgery/2383