<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04447950</url>
  </required_header>
  <id_info>
    <org_study_id>0012-20</org_study_id>
    <nct_id>NCT04447950</nct_id>
  </id_info>
  <brief_title>Randomized Control Trial of Quadratus Lumborum Block for Lumbar Spine Decompression and Fusion Surgery</brief_title>
  <official_title>A Randomized, Double Blind, Placebo Controlled Evaluation Trial of the Benefit in Quadratus Lumborum Block as a Postoperative Analgesic Technique for a Lumbar Spine Decompression and Fusion Surgery</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Assuta Medical Center</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Assuta Medical Center</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Lumbar spinal decompression and fusion is a commonly performed procedure fro neural&#xD;
      impingement and back pain from a variety of pathologies. The importance of pain control in&#xD;
      the postoperative period for spinal surgery has been discussed and proven extensively, with&#xD;
      both immediate and delayed reduction in complications and improved clinical results.&#xD;
&#xD;
      Quadratus lumborum (QL) block was introduced in 2007 and is performed under ultrasound&#xD;
      guidance for perioperative pain management in various surgeries.However, the plane for a&#xD;
      posterior QL block can be easily reached during open midline spinal surgery.&#xD;
&#xD;
      The investigators hypothesize that the posterior QL block is an effective analgesic tool for&#xD;
      lumbar laminectomy surgery, because in lumbar laminectomy the quadratus lumborum is already&#xD;
      exposed and is in direct visual contact. For that reason it is imperative to test the&#xD;
      benefits of this procedure.&#xD;
&#xD;
      This is a double blinded randomized control study to assess the results of intra-operative QL&#xD;
      block performed for lumbar decompression and fusion.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Spinal decompression is a surgical procedure that is performed to alleviate pain caused by&#xD;
      pinched nerves (neural impingement). Surgical options for decompressing the lumbar spine vary&#xD;
      from minimally invasive disc decompression to open laminectomy and foraminotomy. The lumbar&#xD;
      spine decompression and fusion differs from a microdiscectomy in that the incision is longer&#xD;
      and there is more muscle stripping. Lumbar spinal decompression is a commonly performed&#xD;
      procedure and the conventional open techniques of decompression remain the gold standard of&#xD;
      treatment.&#xD;
&#xD;
      During a lumbar decompression back surgery, a small portion of the bone over the nerve root&#xD;
      and/or disc material from under the nerve root is removed to give the nerve root more space&#xD;
      and provide a better healing environment. A lumbar spine decompression and fusion is&#xD;
      typically performed to relieve the lumbar spinal stenosis symptoms. The goal of the surgery&#xD;
      is to allow more space for the nerve root, thus reducing pain (and potentially any leg&#xD;
      weakness or neurological symptoms) and restoring the patient's ability to participate in&#xD;
      everyday activities[1].&#xD;
&#xD;
      Quadratus lumborum (QL) block was introduced in 2007 and is performed for perioperative pain&#xD;
      management in various abdominal, pelvic, gynecological and hip procedures in all age&#xD;
      groups[2]. Four types of QL block were described, differentiated by the exact location of the&#xD;
      anesthetic injection. Type 1/lateral QL block is performed at the lateral border of the QL&#xD;
      muscle, type 2/posterior QL block is performed at the medial edge of the QL muscle (at the&#xD;
      border or the spine erector muscles and the thoraco-lumbar fascia), type 3/anterior is&#xD;
      performed between the QL muscle and the psoas major and type 4 is intramuscular (see figure&#xD;
      1). In the majority of cases, these blocks are performed pre/post operatively under&#xD;
      ultrasound guidance. There are sporadic reports of QL block performed for lumbar spinal&#xD;
      surgery [3, 4].However, the plane for a type 2 QL block can be easily reached during open&#xD;
      midline spinal surgery.&#xD;
&#xD;
      The importance of pain control in the postoperative period for spinal surgery has been&#xD;
      discussed and proven extensively, with both immediate and delayed reduction in complications&#xD;
      and improved clinical results [5, 6].&#xD;
&#xD;
      The investigators hypothesize that the type 2 QL block is an effective analgesic tool for&#xD;
      lumbar laminectomy surgery, because in lumbar laminectomy the quadratus lumborum is already&#xD;
      exposed and is in direct visual contact. For that reason it is imperative, in our opinion, to&#xD;
      test its benefits of this procedure.&#xD;
&#xD;
      Study's objective:&#xD;
&#xD;
      To test the safety and efficacy of open quadratus lumborum block as an add-on postoperative&#xD;
      analgesic technique for lumbar spine decompression and fusion.&#xD;
&#xD;
      Study design:&#xD;
&#xD;
      This is a pilot comparative study, double blind and placebo controlled . Patients scheduled&#xD;
      for a lumbar spine decompression and fusion will be divided randomly into two groups of N=50&#xD;
      each. Subjects in both groups will receive an intra-operative exposure of the posterior QL&#xD;
      block plane, with injection of long acting local anesthetic for group A and Saline for group&#xD;
      B. Both groups will be monitored during their admission in the department for opioid dose&#xD;
      administered, reported pain levels (NRS), narcotics side effects (delirium, urinary&#xD;
      retention, falls) and general operative complications. Patient pain levels, satisfaction and&#xD;
      general complications will be gathered during clinic follow up.&#xD;
&#xD;
      Methods:&#xD;
&#xD;
      Patients arriving to undergo lumbar spine decompression and fusion will be offered to&#xD;
      participate in the study. They will receive a thorough explanation about the study and will&#xD;
      sign an informed consent form. The division into each group will be done randomly on a one by&#xD;
      one basis, by an operating room nurse. The scrubbed nurse will be exposed to the nature of&#xD;
      the substance injected for its sterile preparation, however the surgeons will be blinded to&#xD;
      it. Patients will be blinded to their study arm until the end of the study. The lumbar&#xD;
      laminectomy (open decompression) procedure will be performed as usual:&#xD;
&#xD;
        -  First, the back is approached through a two-inch to five-inch long incision in the&#xD;
           midline of the back, and the left and right back muscles (erector spinae) are dissected&#xD;
           off the lamina on both sides and at multiple levels.&#xD;
&#xD;
        -  After the spine is approached, the lamina is removed (laminectomy), allowing&#xD;
           visualization of the nerve roots.&#xD;
&#xD;
        -  The facet joints, which are directly over the nerve roots, may then be undercut&#xD;
           (trimmed) to give the nerve roots more room.&#xD;
&#xD;
        -  Fusion will be performed with pedicular screws and rods and when indicated an interbody&#xD;
           device.&#xD;
&#xD;
      Study group A will be given an analgesic injection into the quadratus lumborum, comprising of&#xD;
      Marcaine 0.25% with normal saline (for a total of 20 ml per side). Study group B will receive&#xD;
      an identical procedure, however with 20 ml normal saline alone per side. Time required to&#xD;
      perform the block for both sides will be measured.&#xD;
&#xD;
      The postoperative regime will include a standardized pain protocol as is used in routine&#xD;
      practice. all other operative or postoperative procedures are the same for both groups. Data&#xD;
      will be collected from nurses and physical therapy as well as discharge notes. A standardized&#xD;
      form for obtaining data will be used in clinic follow up at 2-3 weeks and 3-4 months.&#xD;
&#xD;
      Safety data collected:&#xD;
&#xD;
      A subjective report of each patient regarding any adverse events will be collected by the&#xD;
      study nurse during their recovery. The surgeon will report at the end of each operation if&#xD;
      there were any adverse events and level of difficulty administrating the injection on&#xD;
      designated forms.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Not yet recruiting</last_known_status>
  <start_date type="Anticipated">June 2020</start_date>
  <completion_date type="Anticipated">August 2021</completion_date>
  <primary_completion_date type="Anticipated">May 2021</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <intervention_model_description>2 arms of a RCT.</intervention_model_description>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Triple (Participant, Care Provider, Investigator)</masking>
    <masking_description>Rotating nurse assigning the arm, scrubbed nurse preparing syringe for injection with a clear liquid - saline vs saline and Marcaine, surgeon blinded to type of liquid in syringe.</masking_description>
  </study_design_info>
  <primary_outcome>
    <measure>Change in the use of post-operative narcotics</measure>
    <time_frame>Will be reported for each postoperative day during the inpatient stay of the patient to a maximum of 7 days.</time_frame>
    <description>Difference in MME (morphine milligrams equivalent) of inpatient narcotics consumption.</description>
  </primary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">100</enrollment>
  <condition>Spinal Stenosis Lumbar</condition>
  <condition>Spondylolisthesis</condition>
  <condition>Fusion of Spine, Lumbar Region</condition>
  <condition>Degeneration Spine</condition>
  <arm_group>
    <arm_group_label>Study group</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Posterior QL block with 20-40 cc of Bupivocaine in posterior border of Quadratum Lumborum muscle at the end of the operation.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Placebo group</arm_group_label>
    <arm_group_type>Placebo Comparator</arm_group_type>
    <description>Posterior QL block with 40 cc of Saline in posterior border of Quadratum Lumborum muscle at the end of the operation.</description>
  </arm_group>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Type 2/posterior Quadratus Lumborum block</intervention_name>
    <description>Injection of local anaesthetic into posterior boundry of Quadratus Lumborum muscle.</description>
    <arm_group_label>Study group</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Placebo block with Saline</intervention_name>
    <description>Injection of saline into posterior boundary of Quadratus Lumborum muscle.</description>
    <arm_group_label>Placebo group</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Men and women at the ages of 18-80 suffering from leg + back pain or neurological&#xD;
             claudication.&#xD;
&#xD;
          -  Undergoing an elective 1-3 level lumbar laminectomy &amp; fusion at Assuta medical center.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Chronic narcotic treatment (more than 3 months)&#xD;
&#xD;
          -  Current active Infection.&#xD;
&#xD;
          -  Underwent any other major operation in the last two months.&#xD;
&#xD;
          -  Known hypersensitivity to local anaesthetic&#xD;
&#xD;
          -  Previous lumbar instrumentation (revision of decompression to decompression with&#xD;
             fusion will be included)&#xD;
&#xD;
          -  Non Ambulatory patients&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>80 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Ely Ashkenazy, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Neurosurgeon, Assuta medical center</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Ely Ashkenazy, MD</last_name>
    <phone>+972-3-7645400</phone>
    <email>ashkenazy@isc.co.il</email>
  </overall_contact>
  <location>
    <facility>
      <name>The Israeli spine center, Assuta medical center</name>
      <address>
        <city>Tel Aviv</city>
        <zip>69710</zip>
        <country>Israel</country>
      </address>
    </facility>
    <contact>
      <last_name>Ely Ashkenazy, MD</last_name>
      <phone>+972-3-7645400</phone>
      <email>ashkenazy@isc.co.il</email>
    </contact>
  </location>
  <location_countries>
    <country>Israel</country>
  </location_countries>
  <reference>
    <citation>Benz RJ, Garfin SR. Current techniques of decompression of the lumbar spine. Clin Orthop Relat Res. 2001 Mar;(384):75-81. doi: 10.1097/00003086-200103000-00010.</citation>
    <PMID>11249182</PMID>
  </reference>
  <reference>
    <citation>Elsharkawy H. Quadratus Lumborum Blocks. Adv Anesth. 2017;35(1):145-157. doi: 10.1016/j.aan.2017.07.007. Epub 2017 Oct 3. No abstract available.</citation>
    <PMID>29103570</PMID>
  </reference>
  <reference>
    <citation>Iwamitsu R, Ueshima H, Otake H. RETRACTED: Intermittent bilateral posterior quadratus lumborum block was effective for pain management in lumbar spinal fusion. J Clin Anesth. 2017 Nov;42:16. doi: 10.1016/j.jclinane.2017.08.012. Epub 2017 Aug 6. No abstract available.</citation>
    <PMID>28793274</PMID>
  </reference>
  <reference>
    <citation>Ueshima H, Otake H. RETRACTED: Clinical experience of anterior quadratus lumborum block after lumber surgery. J Clin Anesth. 2017 Feb;37:131. doi: 10.1016/j.jclinane.2016.12.014. Epub 2017 Jan 9. No abstract available.</citation>
    <PMID>28235503</PMID>
  </reference>
  <reference>
    <citation>Yoo JS, Ahn J, Buvanendran A, Singh K. Multimodal analgesia in pain management after spine surgery. J Spine Surg. 2019 Sep;5(Suppl 2):S154-S159. doi: 10.21037/jss.2019.05.04.</citation>
    <PMID>31656869</PMID>
  </reference>
  <reference>
    <citation>Pugely AJ, Martin CT, Gao Y, Mendoza-Lattes S. Causes and risk factors for 30-day unplanned readmissions after lumbar spine surgery. Spine (Phila Pa 1976). 2014 Apr 20;39(9):761-8. doi: 10.1097/BRS.0000000000000270.</citation>
    <PMID>24525993</PMID>
  </reference>
  <reference>
    <citation>McDonnell JG, O'Donnell B, Curley G, Heffernan A, Power C, Laffey JG. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesth Analg. 2007 Jan;104(1):193-7. doi: 10.1213/01.ane.0000250223.49963.0f. Erratum In: Anesth Analg. 2007 May;104(5):1108.</citation>
    <PMID>17179269</PMID>
  </reference>
  <verification_date>June 2020</verification_date>
  <study_first_submitted>June 20, 2020</study_first_submitted>
  <study_first_submitted_qc>June 24, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">June 25, 2020</study_first_posted>
  <last_update_submitted>June 24, 2020</last_update_submitted>
  <last_update_submitted_qc>June 24, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">June 25, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Assuta Medical Center</investigator_affiliation>
    <investigator_full_name>Ely Ashkenazy</investigator_full_name>
    <investigator_title>Dr Ely Ashkenazy, neurosurgeon</investigator_title>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Spinal Stenosis</mesh_term>
    <mesh_term>Spondylolisthesis</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04447950
org study id: 0012-20
nct id: NCT04447950
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
Lumbar spinal decompression and fusion is a commonly performed procedure fro neural
      impingement and back pain from a variety of pathologies. The importance of pain control in
      the postoperative period for spinal surgery has been discussed and proven extensively, with
      both immediate and delayed reduction in complications and improved clinical results.

      Quadratus lumborum (QL) block was introduced in 2007 and is performed under ultrasound
      guidance for perioperative pain management in various surgeries.However, the plane for a
      posterior QL block can be easily reached during open midline spinal surgery.

      The investigators hypothesize that the posterior QL block is an effective analgesic tool for
      lumbar laminectomy surgery, because in lumbar laminectomy the quadratus lumborum is already
      exposed and is in direct visual contact. For that reason it is imperative to test the
      benefits of this procedure.

      This is a double blinded randomized control study to assess the results of intra-operative QL
      block performed for lumbar decompression and fusion.
Spinal decompression is a surgical procedure that is performed to alleviate pain caused by
      pinched nerves (neural impingement). Surgical options for decompressing the lumbar spine vary
      from minimally invasive disc decompression to open laminectomy and foraminotomy. The lumbar
      spine decompression and fusion differs from a microdiscectomy in that the incision is longer
      and there is more muscle stripping. Lumbar spinal decompression is a commonly performed
      procedure and the conventional open techniques of decompression remain the gold standard of
      treatment.

      During a lumbar decompression back surgery, a small portion of the bone over the nerve root
      and/or disc material from under the nerve root is removed to give the nerve root more space
      and provide a better healing environment. A lumbar spine decompression and fusion is
      typically performed to relieve the lumbar spinal stenosis symptoms. The goal of the surgery
      is to allow more space for the nerve root, thus reducing pain (and potentially any leg
      weakness or neurological symptoms) and restoring the patient's ability to participate in
      everyday activities[1].

      Quadratus lumborum (QL) block was introduced in 2007 and is performed for perioperative pain
      management in various abdominal, pelvic, gynecological and hip procedures in all age
      groups[2]. Four types of QL block were described, differentiated by the exact location of the
      anesthetic injection. Type 1/lateral QL block is performed at the lateral border of the QL
      muscle, type 2/posterior QL block is performed at the medial edge of the QL muscle (at the
      border or the spine erector muscles and the thoraco-lumbar fascia), type 3/anterior is
      performed between the QL muscle and the psoas major and type 4 is intramuscular (see figure
      1). In the majority of cases, these blocks are performed pre/post operatively under
      ultrasound guidance. There are sporadic reports of QL block performed for lumbar spinal
      surgery [3, 4].However, the plane for a type 2 QL block can be easily reached during open
      midline spinal surgery.

      The importance of pain control in the postoperative period for spinal surgery has been
      discussed and proven extensively, with both immediate and delayed reduction in complications
      and improved clinical results [5, 6].

      The investigators hypothesize that the type 2 QL block is an effective analgesic tool for
      lumbar laminectomy surgery, because in lumbar laminectomy the quadratus lumborum is already
      exposed and is in direct visual contact. For that reason it is imperative, in our opinion, to
      test its benefits of this procedure.

      Study's objective:

      To test the safety and efficacy of open quadratus lumborum block as an add-on postoperative
      analgesic technique for lumbar spine decompression and fusion.

      Study design:

      This is a pilot comparative study, double blind and placebo controlled . Patients scheduled
      for a lumbar spine decompression and fusion will be divided randomly into two groups of N=50
      each. Subjects in both groups will receive an intra-operative exposure of the posterior QL
      block plane, with injection of long acting local anesthetic for group A and Saline for group
      B. Both groups will be monitored during their admission in the department for opioid dose
      administered, reported pain levels (NRS), narcotics side effects (delirium, urinary
      retention, falls) and general operative complications. Patient pain levels, satisfaction and
      general complications will be gathered during clinic follow up.

      Methods:

      Patients arriving to undergo lumbar spine decompression and fusion will be offered to
      participate in the study. They will receive a thorough explanation about the study and will
      sign an informed consent form. The division into each group will be done randomly on a one by
      one basis, by an operating room nurse. The scrubbed nurse will be exposed to the nature of
      the substance injected for its sterile preparation, however the surgeons will be blinded to
      it. Patients will be blinded to their study arm until the end of the study. The lumbar
      laminectomy (open decompression) procedure will be performed as usual:

        -  First, the back is approached through a two-inch to five-inch long incision in the
           midline of the back, and the left and right back muscles (erector spinae) are dissected
           off the lamina on both sides and at multiple levels.

        -  After the spine is approached, the lamina is removed (laminectomy), allowing
           visualization of the nerve roots.

        -  The facet joints, which are directly over the nerve roots, may then be undercut
           (trimmed) to give the nerve roots more room.

        -  Fusion will be performed with pedicular screws and rods and when indicated an interbody
           device.

      Study group A will be given an analgesic injection into the quadratus lumborum, comprising of
      Marcaine 0.25% with normal saline (for a total of 20 ml per side). Study group B will receive
      an identical procedure, however with 20 ml normal saline alone per side. Time required to
      perform the block for both sides will be measured.

      The postoperative regime will include a standardized pain protocol as is used in routine
      practice. all other operative or postoperative procedures are the same for both groups. Data
      will be collected from nurses and physical therapy as well as discharge notes. A standardized
      form for obtaining data will be used in clinic follow up at 2-3 weeks and 3-4 months.

      Safety data collected:

      A subjective report of each patient regarding any adverse events will be collected by the
      study nurse during their recovery. The surgeon will report at the end of each operation if
      there were any adverse events and level of difficulty administrating the injection on
      designated forms.
allocation: Randomized
intervention model: Parallel Assignment
intervention model description: 2 arms of a RCT.
primary purpose: Treatment
masking: Triple (Participant, Care Provider, Investigator)
masking description: Rotating nurse assigning the arm, scrubbed nurse preparing syringe for injection with a clear liquid - saline vs saline and Marcaine, surgeon blinded to type of liquid in syringe.
measure: Change in the use of post-operative narcotics
time frame: Will be reported for each postoperative day during the inpatient stay of the patient to a maximum of 7 days.
description: Difference in MME (morphine milligrams equivalent) of inpatient narcotics consumption.
arm group label: Study group
arm group type: Experimental
description: Posterior QL block with 20-40 cc of Bupivocaine in posterior border of Quadratum Lumborum muscle at the end of the operation.
arm group label: Placebo group
arm group type: Placebo Comparator
description: Posterior QL block with 40 cc of Saline in posterior border of Quadratum Lumborum muscle at the end of the operation.
intervention type: Procedure
intervention name: Type 2/posterior Quadratus Lumborum block
description: Injection of local anaesthetic into posterior boundry of Quadratus Lumborum muscle.
arm group label: Study group
intervention type: Procedure
intervention name: Placebo block with Saline
description: Injection of saline into posterior boundary of Quadratus Lumborum muscle.
arm group label: Placebo group
criteria: 
gender: All
minimum age: 18 Years
maximum age: 80 Years
healthy volunteers: No
last name: Ely Ashkenazy, MD
role: Principal Investigator
affiliation: Neurosurgeon, Assuta medical center
last name: Ely Ashkenazy, MD
phone: +972-3-7645400
email: ashkenazy@isc.co.il
facility: 
contact: 
country: Israel
citation: Benz RJ, Garfin SR. Current techniques of decompression of the lumbar spine. Clin Orthop Relat Res. 2001 Mar;(384):75-81. doi: 10.1097/00003086-200103000-00010.
PMID: 11249182
citation: Elsharkawy H. Quadratus Lumborum Blocks. Adv Anesth. 2017;35(1):145-157. doi: 10.1016/j.aan.2017.07.007. Epub 2017 Oct 3. No abstract available.
PMID: 29103570
citation: Iwamitsu R, Ueshima H, Otake H. RETRACTED: Intermittent bilateral posterior quadratus lumborum block was effective for pain management in lumbar spinal fusion. J Clin Anesth. 2017 Nov;42:16. doi: 10.1016/j.jclinane.2017.08.012. Epub 2017 Aug 6. No abstract available.
PMID: 28793274
citation: Ueshima H, Otake H. RETRACTED: Clinical experience of anterior quadratus lumborum block after lumber surgery. J Clin Anesth. 2017 Feb;37:131. doi: 10.1016/j.jclinane.2016.12.014. Epub 2017 Jan 9. No abstract available.
PMID: 28235503
citation: Yoo JS, Ahn J, Buvanendran A, Singh K. Multimodal analgesia in pain management after spine surgery. J Spine Surg. 2019 Sep;5(Suppl 2):S154-S159. doi: 10.21037/jss.2019.05.04.
PMID: 31656869
citation: Pugely AJ, Martin CT, Gao Y, Mendoza-Lattes S. Causes and risk factors for 30-day unplanned readmissions after lumbar spine surgery. Spine (Phila Pa 1976). 2014 Apr 20;39(9):761-8. doi: 10.1097/BRS.0000000000000270.
PMID: 24525993
citation: McDonnell JG, O'Donnell B, Curley G, Heffernan A, Power C, Laffey JG. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesth Analg. 2007 Jan;104(1):193-7. doi: 10.1213/01.ane.0000250223.49963.0f. Erratum In: Anesth Analg. 2007 May;104(5):1108.
PMID: 17179269
responsible party type: Principal Investigator
investigator affiliation: Assuta Medical Center
investigator full name: Ely Ashkenazy
investigator title: Dr Ely Ashkenazy, neurosurgeon
mesh term: Spinal Stenosis
mesh term: Spondylolisthesis
sharing ipd: No