Spinal block against spinal compression fracture

Abstract

A spinal block was performed on 11 patients with spinal compression fractures not associated with nerve injury. The drugs used were either 3 ml of 1% Mepivacaine hydrochloride or 1% Lidocaine containing 1.9-3.8 mg of Dexamethasone sodium phosphate, with the dosage decreased appropriately for elderly patients. Post block, patients were immobilized for three hours in a pelvis-down tilt position at about 45 degrees. One day following the block, a body cast was applied that fixed the spine but which allowed patients to ambulate. For evaluation of pain, the 5-point NRS score was used and the degree of improvement was assessed based on the patients' NRS score pre-and post-block. Pre-block pain scores averaging 4.8 showed a 65% improvement at 48 hours, post-block. All patients underwent an MRI, and no patients showed a burst fracture. The mean duration of a hospitalization for patients in this study was 12 days. Follow up examinations conducted at a mean of nine months post-injury showed a clear improvement in the low back pain. The only complication noted was slight headache in one patient. There were no serious complicaions. This treatment protocol deserves further attention as a fast and effective method of pain reduction in acute compression fracture.