Cervical Erector Spinae Plane Block in a Patient with Failed Neck Surgery Syndrome: A Case Report and Literature Review

Abstract

Introduction: Failed neck surgery syndrome (FNSS) following posterior cervical spine fusion (PSF) presents a considerable challenge in pain management. Objective: This study aims to report the potential utility of the cervical erector spinae plane block (ESPB) as an influential adjunctive therapy in a patient with FNSS who was refractory to medical therapy and unable to undergo spinal cord stimulation (SCS) due to financial constraints. Methods: This case report details a 74-year-old male with persistent, debilitating axial neck pain lasting one year following PSF, without neural or motor deficits, and with device failure ruled out. Given the risks of cervical epidural steroid injection in this patient, a fluoroscopically guided bilateral cervical ESPB at the C7 level was administered for temporary pain relief. Result: This technique was associated with substantial pain relief and improved functional outcomes, as demonstrated by reductions in the Numerical Rating Scale (NRS) and Neck Disability Index (NDI) scores. Conclusion: This case underscores the potential utility of the cervical ESPB as an effective adjunctive therapy for managing pain in FNSS, providing a minimally invasive alternative to conventional treatment approaches.