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

World Neurosurg. 2024 Dec:192:63-67. doi: 10.1016/j.wneu.2024.08.116. Epub 2024 Aug 28.

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.

Keywords: Intercostal nerve block; Intraoperative technique; Pain management; Spine surgery; Thoracic discectomy.

MeSH terms

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