Abstract:
Background. Cellular spaces, also referred to as interfascial planes, represent anatomical
compartments formed by loose connective tissue and delimited by fasciae, muscles, bones, and other
structural elements. These spaces may contain blood vessels, nerves, and lymph nodes and play an
important role in facilitating the mobility and interaction of anatomical structures. In pathological
conditions, particularly infectious processes, they can also serve as pathways for the spread of purulent
collections. Recent anatomical and imaging studies have redefined the cellular space as the plane
between two layers of the deep fascia, composed primarily of adipose tissue, elastin, and reticular
fibers. In recent years, these interfascial planes have gained increasing importance in regional
anesthesia, particularly in the development of fascial plane blocks, which are widely used due to their
safety and technical simplicity.
Aim of the study. The aim of this study was to highlight the anatomical and clinical significance of
interfascial cellular spaces, with particular emphasis on the erector spinae plane, and to underline their
relevance in the performance of fascial plane blocks used for postoperative and chronic pain
management.
Results. The analysis of the anatomical characteristics of the erector spinae interfascial plane
demonstrates that this space is located between the erector spinae muscle and the transverse processes
of the vertebrae. Within this plane run the dorsal and ventral rami of the spinal nerves, which can be
effectively anesthetized following the administration of local anesthetic. The spread of the anesthetic
solution occurs both cranially (approximately 1–3 vertebral levels) and caudally from the injection site,
allowing the blockade of multiple dermatomes. This anatomical distribution explains the effectiveness
of the erector spinae plane block in providing analgesia for a variety of surgical procedures as well as
for the treatment of acute and chronic pain conditions.
Conclusion. A thorough understanding of topographic anatomy and interfascial cellular spaces is
essential for performing medico-surgical procedures with minimal complications. The evolution of
fascial plane blocks from landmark-based techniques to ultrasound-guided approaches has
significantly increased their safety and accuracy. Consequently, locoregional anesthesia techniques,
particularly fascial plane blocks such as the erector spinae plane block, are expected to gain wider
applicability across both surgical and therapeutic medical specialties.
