Safety of neurolytic erector spinae plane blocks for cancer pain

In reply: A safer step-by-step approach for erector spinae plane phenol neurolytic blocks

“…In our previous letter to the Editor, 2 we pointed out the long-term implications of possible paraspinal muscle atrophy following ESPB-phenol neurolysis, which might adversely impair the spinal balance and global alignment. This concept has been proposed by other researchers and was well-illustrated in a recent paper regarding an ESPB's ability to affect the function of paraspinal muscles as a stabilizer of the vertebral column.…”

“…I read with interest the comments by Dr. Rocha-Romero et al, 1 in response to our article entitled ''Safety of neurolytic erector spinae plane blocks for cancer pain''. 2 The authors point to some interesting issues that I would like to respond to.…”

A safer step-by-step approach for erector spinae plane phenol neurolytic blocks

“…We read with great interest the recent letter by Elkoundi et al 1 about the concern with the erector spinae plane (ESP) phenol neurolytic block. We would like to illustrate our own experience performing what we consider a safer step-by-step approach to this block.…”

“…We previously described ESP phenol spread 3 and have subsequently obtained satisfactory results in several patients, similar to what others have reported. 4 Although Elkoundi et al 1 highlighted the potential effect on the dorsal rami, this should not be a great concern, particularly as this is a typical target for pain physicians treating facet joint pain with radiofrequency ablation. 5 Previous publications rapidly transition from a diagnostic ESP block to a neurolytic block.…”