Stereotactic Lumbar Sympathectomy: A New Modification: Case report / 대한마취과학회지

ABSTRACT

Neurolytic or surgical lumbar sympathectomy are commonly used in the treatment of intractable pain and peripheral ischemia. The primary goal of sympathectomy for pain management is to achieve a good result with minimal interruption of nervous tissue and as few side effect as possible. A high incidence of postoperative bleeding, ureteral injuries have been reported in surgical sympathectomy and chemical neuritis or paresthesia has been reported with an incidence of 2~10% in nerurolytic sympathectomy. Of the techniques which have been applied for sympathectomy, the radiofrequency lesion method has emerged as the most effective with less complications. But, a series of modifications have been tried in an effort to improve results. The more extensive lesions are thought to produce the more effective sympatholysis. We inserted two cannulas for making lesions to one ganglion and 3 or 4 lesions were made at each level. Sympathectomy using this technique was successful in thirteen out of fifteen patients. This new modified technique has improved the effectiveness of stereotactic radiofrequency lumbar sympathectomy as compared with other previous reports.