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Research ArticleNovel Techniques & Technology

Feasibility and Analgesic Efficacy of Thoracolumbar Dorsal Ramus Nerve Block Using Multiorifice Pain Catheters for Scoliosis Surgery: A Prospective Cohort Study

Tara M. Doherty, Ailan Zhang, Alla Spivak, Ellen Kiley, Damon DelBello, Apolonia E. Abramowicz and Jeff L. Xu
International Journal of Spine Surgery May 2024, 8601; DOI: https://doi.org/10.14444/8601
Tara M. Doherty
1 Department of Anesthesiology, Westchester Medical Center/New York Medical College, Valhalla, NY, USA
DO
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Ailan Zhang
1 Department of Anesthesiology, Westchester Medical Center/New York Medical College, Valhalla, NY, USA
MD, PHD
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Alla Spivak
1 Department of Anesthesiology, Westchester Medical Center/New York Medical College, Valhalla, NY, USA
DO
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Ellen Kiley
2 Department of Public Health, New York Medical College School of Health Sciences and Practice, Valhalla, NY, USA
MPH
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Damon DelBello
3 Department of Orthopedic Surgery, Westchester Medical Center/New York Medical College, Valhalla, NY, USA
MD
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Apolonia E. Abramowicz
1 Department of Anesthesiology, Westchester Medical Center/New York Medical College, Valhalla, NY, USA
MD
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Jeff L. Xu
1 Department of Anesthesiology, Westchester Medical Center/New York Medical College, Valhalla, NY, USA
MD
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  • For correspondence: jeff.xu@wmchealth.org
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    Figure 1

    Intraoperative placement of thoracolumbar dorsal ramus nerve catheter within the anatomy of the back. Published with permission from the International Journal of Spine Surgery.17

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    Figure 2

    Thoracolumbar dorsal ramus nerve catheters in place prior to surgical closure. Published with permission from the International Journal of Spine Surgery.17

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    Figure 3

    Box and whisker plot representing numeric rating scale pain scores at 0–12 and 13–24 hours postoperatively.

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    Figure 4

    Opioid consumption represented in mean morphine milligram equivalents at 0–12- and 13–24-hour periods.

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    Table 1

    Patient demographic and basic clinical characteristics (N = 40).

    Characteristics n MeanRangeSD
    Sex, n
     Men13   
     Women27   
    Age, y 14.3911–212.02
    Body weight, kg 57.3937–10016.73
    Cobb angle, degrees
     Preoperative 53.526–8310.5
     Postoperative 16.32–5610.3
    Total mean opioid
     MME/per 0–12 h 9.240–19.46.6
     MME/per 13–24 h 16.80–35.212.6
     MME/kg/0–12 h 0.160–0.440.1
     MME/kg/13–24 h 0.2470–0.770.17
    Postoperative NRS pain score
     12 h postoperative 2.750–72.12
     13–24 h postoperative 3.100–92.3
    • Abbreviations: MME: morphine milligram equivalents; NRS: Numeric Rating Scale.

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    Table 2

    Summary of similar studies comparing opioid consumption in scoliosis surgery.

    Reference StudyMME DataOur Study MME Data
    Thomson et al22 42.3 mg/24 h26 mg/24 h
    Kim et al23 35.8 mg/24 h26 mg/24 h
    Chan et al24 51 mg/24 h26 mg/24 h
    Walters et al25 0.703 mg/kg/24 h0.4 mg/kg/24 h
    • Abbreviation: MME: morphine milligram equivalents.

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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Feasibility and Analgesic Efficacy of Thoracolumbar Dorsal Ramus Nerve Block Using Multiorifice Pain Catheters for Scoliosis Surgery: A Prospective Cohort Study
Tara M. Doherty, Ailan Zhang, Alla Spivak, Ellen Kiley, Damon DelBello, Apolonia E. Abramowicz, Jeff L. Xu
International Journal of Spine Surgery May 2024, 8601; DOI: 10.14444/8601

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Feasibility and Analgesic Efficacy of Thoracolumbar Dorsal Ramus Nerve Block Using Multiorifice Pain Catheters for Scoliosis Surgery: A Prospective Cohort Study
Tara M. Doherty, Ailan Zhang, Alla Spivak, Ellen Kiley, Damon DelBello, Apolonia E. Abramowicz, Jeff L. Xu
International Journal of Spine Surgery May 2024, 8601; DOI: 10.14444/8601
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Keywords

  • adolescent idiopathic scoliosis
  • posterior spinal fusion surgery
  • postoperative pain management
  • thoracolumbar dorsal ramus nerve (TDRN) block
  • multi-orifice catheter
  • Enhanced Recovery After Surgery

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