Efficacy and safety of erector spinae plane block in non-specific low back pain: an exploratory systematic review

INTRODUCTION: There is a lack of consolidated evidence to definitively establish the efficacy and safety of ultrasound-guided erector spinae plane block (ESPB) for low back pain (LBP).Our review aimed to summarize the current published evidence regarding the analgesic efficacy and safety of ESPB in LBP. METHOD: We conducted a systematic review in accordance with the PRISMA guidelines. The review protocol has been registered in PROSPERO. RESULTS: The literature search yielded 21 potentially relevant publications. 232 articles were excluded. The number of patients treated with ESPB was 501. The ESPB's efficacy in reducing the patient's perceived pain was demonstrated in 216 of 345 cases on the first day, 270 of 319 cases in the first month, and 265 of 295 cases in the third month. Exacerbation of pain was reported by 2 patients in the first month after ESPB. Side effects were reported in 5 cases. CONCLUSION: Current evidence is limited to low-level studies. While preliminary findings showed that ESPB was a minimally invasive method that provided analgesia in patients with acute and chronic LBP with or without radicular pain, strong conclusions cannot be drawn. Future high-quality randomized controlled trials are necessary to guide clinical practice. PROTOCOL REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD42025646263 identifier is CRD42025646263.