Patients with vertebral compression fractures are often indicated for balloon kyphoplasty. Many of them are elderly with severe comorbidities, which puts them at high risk for general anaesthesia. Surgery under infi ltration of local anaesthetic with or without mild sedation is therefore the preferred technique used by many surgeons. However, patients reported moderate-to-severe pain during the procedure. A combination of regional anaesthesia with analgo-sedation offers an interesting alternative to general anaesthesia as well as infi ltration administered by the surgeon. In this article we present, apart from general anaesthesia, various regional anaesthetic techniques suitable for high-risk patients, including neuraxial anaesthesia, paravertebral block as well as a novel "erector spinae plane block" at the level of the fractured vertebra. We explore their effectiveness and safety profi le, as well as advantage of supplementation of adequate analgo-sedation (Ref. 40).
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