Abstract
Objective
To investigate the injectate spread and nerve staining of ultrasound-guided erector
spinae plane (ESP) injections at the thoracolumbar spine in canine cadavers.
Study design
Prospective, randomized, descriptive, anatomic study.
Animals
A total of 15 canine cadavers.
Methods
The location of the medial and lateral branches of the dorsal branches of the spinal
nerves (DBSN) from the tenth thoracic (T10) to the third lumbar vertebra (L3) were
identified by dissection of three cadavers. ESP injections of dye (0.5 mL kg–1) were performed in seven cadavers using as landmarks the T12 transverse process (ESPTp) on one side and the lateral aspect of the T12 mammillary process (ESPMp) on the opposite side. Additionally, five cadavers were injected with dye (0.5 mL
kg–1) bilaterally on the lateral aspect of the L2 mammillary process (ESPMp_L2). Nerve staining effect was analyzed after gross anatomic dissections. The number
of stained nerves was analyzed using the Mann–Whitney U test.
Results
Gross anatomic dissections showed that the medial and lateral branches of the DBSN
change their path in relation to the epaxial muscles caudal to T11. Approaches ESPTp and ESPMp at T12 stained 2 (0–2) and 3 (2–4) medial (p = 0.01) and 3 (3–4) and 2 (0–2) lateral (p = 0.03) branches, respectively. Injection ESPMp_L2 stained 3 (2–4) medial and 2 (0–3) lateral branches. Injections ESPMp and ESPMp_L2 produced a preferential cranial spread from the injection site. No ventral branches
of the spinal nerves were stained with either technique.
Conclusions and clinical relevance
These results suggest that the mammillary process should be used as anatomic landmark
to perform ultrasound-guided ESP blocks in the thoracolumbar spine caudal to T11 when
targeting the medial branches of the DBSN. Injections should be performed one spinal
segment caudal to the level intended to desensitize.
Keywords
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Article Info
Publication History
Published online: August 02, 2022
Accepted:
July 20,
2022
Received:
April 19,
2022
Identification
Copyright
© 2022 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
