Second thoracic sympathetic ganglionectomy in sympathetically maintained pain.
Twenty-four individuals with sympathetically maintained pain were treated by posterior paravertebral T2 sympathectomy following transient response to sympathetic nerve blockade. Eight surgical patients (33.4%) had causalgia, and 16 patients (66.4%) suffered with reflex sympathetic dystrophy. Overall, physical evidence of improvement was noted in 87% of surgical patients, with subjective improvement in 71%. Reflex sympathetic dystrophy patients fared better than those with causalgia. Complications were minor. The techniques employed appear safe and effective; a multidisciplinary approach with neurosurgery, physiatry, anesthesiology, psychology, and allied health services is recommended.
Herz
D A
DA
Division of Neurosurgery, Michigan State University.
Looman
J E
JE
Ford
R D
RD
Gostine
M L
ML
Davis
F N
FN
VandenBerg
W C
WC
D000328:Adult; D002422:Causalgia / Q000601:surgery; D005260:Female; D015171:Ganglionectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology* / Q000601:surgery; D010166:Palliative Care; D012019:Reflex Sympathetic Dystrophy / Q000601:surgery; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D013904:Thoracic Vertebrae / Q000294:innervation*