Evaluating the Efficacy of Cervical Erector Spinae Plane Block Using Ultrasound Versus Fluoroscopic Guidance for Cervical Pain: A Case Series

Abstract

Background: The erector spinae plane block (ESPB) has traditionally been performed under ultrasound guidance, while fluoroscopic guidance has emerged as an alternative approach. Objectives: This study aims to compare the efficacy of ESPB using ultrasound and fluoroscopic guidance in patients with cervical pain. Methods: This case series study includes fourteen patients with axial neck pain scheduled for cervical ESPB. According to the approach of ESPB (ultrasound or fluoroscopic guidance), patients were divided into two groups: Eight underwent ultrasound-guided ESPB, and six received fluoroscopy-guided ESPB. Pain and disability were assessed using the Numerical Rating Scale (NRS) and the Neck Disability Index (NDI) at baseline (pre-procedure), two weeks post-procedure, and three months post-procedure. Results: Both groups demonstrated significant improvements in NRS and NDI scores over time (P = 0.005). However, no statistically significant differences were observed in pain scores or disability indices at any of the evaluation points. Conclusions: This study suggests that fluoroscopy-guided ESPB is as effective as ultrasound-guided ESPB for managing cervical radicular pain, providing a viable alternative for clinicians.