title: The outcome of percutaneous computed tomography-guided chemical lumbar sympathectomy for patients with causalgia after lumbar discectomy.
abstract: BACKGROUND
  Coldness, numbness, or causalgia usually affects the lower limbs in patients after back surgeries. The treatment of causalgia is still the source of continuing debate. We treated patients presenting with causalgia secondary to LD with CT-guided CLS and determined the therapeutic outcome at long-term follow-up.
  
  
  METHODS
  From January 2002 to December 2002, a total of 15 patients (16 limbs) with causalgia after LD underwent the percutaneous CT-guided CLS. There were 7 male patients and 8 female patients, with an average age of 49.1 years. A total of 14 patients underwent unilateral procedures, and 1 patient underwent staged bilateral procedures. We followed up our patients for at least 24 months (24-36 months).
  
  
  RESULTS
  There were 13 patients (14 limbs) diagnosed as Drucker stage I and 2 patients as stage II. There were 88% (14 limbs) that had an early satisfactory outcome after CLS and 75% (12 limbs) that had a late satisfactory outcome (more than 24 months after CLS). Stage I patients had more satisfying early and late outcome than stage II patients (P= .014 and P= .039, respectively). Female patients were more likely to have satisfactory late outcome than male patients (P= .034). There was no operative mortality. A patient had a complication of genitofemoral neuralgia, which had recovered in a month.
  
  
  CONCLUSIONS
  We concluded that the percutaneous CT-guided CLS is an easy, safe, and reproducible technique, and it carries long-term benefit to patients with pain after LD presenting with causalgia, especially for patients with Drucker stage I and female patients.
authors.affiliation: Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Kung-Shing
authors.initials: KS
authors.lastname: Lee
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Su
authors.forename: Ann-Shung
authors.initials: AS
authors.lastname: Lieu
authors.forename: Chin-Lin
authors.initials: CL
authors.lastname: Chuang
authors.forename: Shiuh-Lin
authors.initials: SL
authors.lastname: Hwang
authors.forename: Shen-Long
authors.initials: SL
authors.lastname: Howng
authors.forename: Chih-Lung
authors.initials: CL
authors.lastname: Lin
mesh_terms: D000328:Adult; D002422:Causalgia / Q000209:etiology* / Q000628:therapy*; D017586:Diskectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013563:Sympathectomy, Chemical / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome