META-ANALYSIS OF ULTRASOUND-GUIDED THORACOLUMBAR FASCIAL PLANE BLOCK FOR MANAGING LUMBAR PAIN IN ATHLETES

Abstract

Objective: This meta-analysis evaluates the effectiveness of ultrasound-guided thoracolumbar fascial plane block (TLIPB) in managing postoperative lumbar pain, specifically in athletes undergoing lumbar spine surgery. Methods: A comprehensive search was conducted across PubMed, EMBASE, Cochrane Library, China HowNet, Wanfang, and Chinese biomedical literature databases through December 2021. We included randomized controlled trials that applied TLIPB in lumbar spine surgery. Relevant studies were selected based on predefined inclusion and exclusion criteria. Data were extracted, the quality of included studies was assessed using Cochrane standards, and meta-analysis was performed using Revman 5.3 software. Outcomes measured included Visual Analog Scale (VAS) scores for pain at rest and during physical activity at 4-, 12-, 24-, and 48-hours post-surgery, need for rescue analgesia at 24 hours, and the incidence of post-operative adverse reactions such as nausea, vomiting, itching, and respiratory depression. Results: Thirteen articles involving 781 patients were analyzed. The TLIPB group demonstrated significantly lower VAS scores compared to the control group at rest and during exercise at all postoperative intervals (P < 0.01), with the most notable improvements observed at 4- and 12-hours post-surgery. The incidence of adverse reactions was also lower in the TLIPB group, suggesting a better safety profile. Conclusion: Ultrasound-guided thoracolumbar fascial plane block significantly reduces postoperative lumbar pain and enhances recovery in athletes following lumbar surgery. The technique offers a viable option for pain management that can be particularly beneficial in sports medicine, where minimizing downtime and facilitating quicker return to training are critical. Future research should focus on long-term outcomes and the integration of TLIPB into broader postoperative rehabilitation protocols for athletes.