Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3111_Библиотеки_им_академика_М_И_Перельмана
.pdf
450 Philip FINCH
to T2 to T3 for facial sweating, T4 for palmar
sweating and T5 for axillary sweating is thought to
reduce undesirable sequelae [20].
Alternative techniques for upper thoracic neurolysis
include the use of neurolytic substances such as
phenol, and radiofrequency thermolesioning.
Despite the use of CT guidance, complications such
as Horner’s syndrome and pneumothorax occur all
too readily [27]. e use of radiofrequency (RF)
thermolesioning offers a number of advantages,
including the precise nature of the lesioning. ere
are some drawbacks with this method, as seen
with the injection of neurolytic agents, including
the development of pneumothorax. e use of
curved blunt needles perhaps reduces the incidence
of this complication [32, 119]. Radiofrequency
lesioning has been described and popularised by
Wilkinson [113, 114]. As with techniques for RF
lesioning of the lumbar sympathetic chain, there
is no easy method for determining the proximity
of the RF electrode tip to the sympathetic chain.
Direct endoscopic methods of lesioning the chain,
largely overcome these difficulties as the ganglia
are identified visually. (Figure 27.14A and Figure
27.14B)
Complications of ETS can be significant in the
short term including death, intrathoracic bleeding
and anaesthetic complications [77]. In the longer
term, compensatory hyperhidrosis is extremely
common and has been recognised since 1933 [90].
Its rate of occurrence is reported to be as high as
67% [121] and even 94% [94]. e development
of complications such as compensatory sweating
can be accompanied by the development of
significant psychological depression [38]. In some,
this complication is sufficiently unpleasant for
patients to request reversal of the surgery, if that
is possible. Compensatory sweating develops more
commonly in males and perhaps develops in all
post-sympathectomy patients but is not perceived
by all. It is therefore an inevitable not an optional
side effect [94]!
Gustatory sweating is also seen post-thoracic
sympathectomy with profuse facial sweating
after eating hot or spicy food. Its occurrence is
reported in 47% of patients treated [121]. Horner’s
syndrome, which can be facially disfiguring, is
reported to occur in up to 3.8% of patients in one
series [121]. Its incidence depends on the definition
of the syndrome as a mild Horner’s syndrome may
Figure 27.12 Thoracic sympathetic chain
Figure 27.13A Stellate ganglion block – A-P C-arm
Figure 27.13B Stellate ganglion block – Oblique
C-arm
https://t.me/medicina_free
451
The Sympathetic Chain
be marked by a miosis detectable only on close
examination [77]. Other complications include
cardiorespiratory effects and even rhinitis [42].
Endoscopic thoracic sympathectomy is considered
to provide excellent results for patients with primary
hyperhidrosis of the upper limb. Plantar sweating
can also be relieved in nearly half of patients treated
[74]. Quality of life measurements are improved
by T4 ETS for upper limb hyperhidrosis [78].
However, a high initial patient satisfaction rate of
95.5% can become as low as 66.7% satisfied, at a
mean of 14.6 years [42].
Although ETS is a minimally invasive and
highly successful method of treating upper limb
hyperhidrosis, these comments must be weighed
against the possibility of significant long-term
side effects, especially compensatory sweating
and Horner’s syndrome, which can even have
medicolegal ramifications.
Sympathetic Blockade and
Sympathectomy in the
Treatment of Pain States
Sympathetic blockade had long been considered a
mainstay of treatment for neuropathic pain states,
especially complex regional pain syndrome (CRPS),
types I and II [7]. Surgical sympathectomy has also
been considered the treatment of choice for severe
burning pain states arising out of nerve injuries
in wartime. e supporting evidence for such
treatment is however lacking.
Early, more rational, use of surgical sympathectomy
appeared with the work of René Leriche during
World War I [10, 62]. Subsequent wartime
experience entrenched sympathectomy as the most
effective means of treating causalgia, a term devised
by Silas Weir Mitchell during the American Civil
War (1864). Further experience in World War II and
data collected from American and British forces led
to statements that “one of the outstanding surgical
lessons that was learned during World War II was
that interruption of the appropriate sympathetic
nerve fibres is almost invariably effective in the
treatment of causalgia” [87]. Long-term studies
of such efficacy are sadly lacking and of course the
conduct of a randomised controlled trial in war
would be difficult, if not impossible.
Similar symptoms and signs, including burning
pain coupled with autonomic features were
subsequently labelled reflex sympathetic dystrophy,
among many other terms, and were thought to arise
from aberrations of the sympathetic nervous system,
but without nerve injury. In an attempt to get away
from such a mechanistic term that perhaps implied
a pathophysiological mechanism, a new taxonomy
(CRPS I and II) was devised in 1995 [98]. e
original International Association for the Study of
Pain criteria were further refined by Hardin et al.
[11]. ere was subsequently a realisation that both
CRPS I and II were part of a clinical continuum
of disorders which may have a common aetiology
[49]. In the new classification, the syndrome was
described as sympathetically maintained pain
(SMP) if it responded to sympathetic blockade. If it
Figure 27.14A RF thoracic chain A-P C-arm
Figure 27.14B RF thoracic chain lateral C-arm
https://t.me/medicina_free
452 Philip FINCH
did not respond, it was described as sympathetically
independent pain (SIP). is dichotomy of terms
also suggests a pathophysiological mechanism. e
involvement of the sympathetic nervous system in
causalgia and reflex sympathetic dystrophy, which
forms the rationale for treatment by sympathetic
interruption, has been increasingly questioned
[12].
In a recent Cochrane collaborative review, Cepeda
and others determined that there have only
been two randomised controlled trials of local
anaesthetic sympathetic blockade for CRPS worthy
of consideration [16]. ey reviewed the likelihood
of sympathetic blockade providing pain relief in
CRPS, the persistence of benefits and the incidence
of side effects. eir conclusions were sobering,
to say the least. ey could make no conclusion
concerning the effectiveness of sympathetic
blockade, the duration of pain relief could not be
estimated, if any, and lastly, the lack of data on
complications, despite the invasive nature of such
blocks, perhaps suggested under-reporting [16].
Cepeda and others in an earlier study indicated
that sympathetic blockade was advocated mainly
on the basis of weak evidence culled from case
series and that only about one-third of patients
obtained full pain relief [17]. All practising pain
physicians have witnessed almost magical responses
of patients with CRPS to sympathetic blockade. It
is possible that these responses may simply be due
to powerful, active placebo effect and further study
is required [5, 36].
Surgical sympathectomy has also come under closer
scrutiny. In an extensive and systematic literature
review, it was noted that a high proportion of
patients undergoing upper or lower limb surgical
sympathectomy had this procedure for primary
hyperhidrosis (84%). A smaller proportion (2.7%)
underwent sympathectomy for pain states. No
controlled trials were found and complications were
three time higher for those undergoing treatment
for pain states [34]. e potentially disabling
complications that can accompany surgical
sympathectomy have been mentioned earlier in this
chapter. e same authors conducted a Cochrane
collaborative review in 2002 and concluded that “the
practice of surgical and chemical sympathectomy
is based on poor quality evidence, uncontrolled
studies and personal experience. Furthermore,
complications of the procedure may be significant,
in terms of both worsening the pain or producing a
new pain syndrome” [64]. In essence, the practice
of sympathectomy for treating neuropathic pain is
based on very weak evidence.
Careful placebo controlled studies of local
anaesthetic sympathetic blockade and neurolysis in
the treatment of CRPS I and II should be strongly
considered. Otherwise, we as pain physicians risk
losing the support of our colleagues, regulatory
authorities and patients alike.
Conclusion
Although still widely used in several fields of
medicine, both sympathetic blockade and
sympathectomy have limited efficacy and potential
for good. Despite initial enthusiasm, the last decade
of the 20th century has seen the emergence of trial
data which have demonstrated the limitations of
these techniques. Undoubted success can be seen in
the area of cancer pain; both in the use of diagnostic
sympathetic blockade with local anaesthetic agents
and in the longer-term treatment of cancer pain
with neurolytic substances. is success is also
seen to some extent in peripheral vascular disease.
However, in the area of cosmetic sympathectomy
for primary hyperhidrosis and in the treatment of
neuropathic pain syndromes, such as CRPS, the
techniques are perhaps over-utilised and one might
even say that they have the potential for abuse
for financial gain. It is hard to argue for multiple
sequential local anaesthetic sympathetic blocks
for CRPS when so few patients respond. Further,
the use of sympathetic blockade may be based on
a flawed premise of autonomic efferent activity.
In the case of sympathectomy for hyperhidrosis,
sympathetic chain ablation has the potential for
replacing one devastating set of symptoms with
another set that are equally devastating and long
lasting.
How should we address this dilemma? First of
all, the active placebo effect must be studied,
especially in the area of treatment of CRPS. More
recent evidence would suggest that this condition
may have an aberration of central nervous system
pain processing as a basis for its pathogenesis. e
active placebo can have powerful central effects and
careful allowance for this phenomenon must be
made in any future trials of efficacy of sympathetic
blockade.
https://t.me/medicina_free
453
The Sympathetic Chain
As a better understanding of the role of the
sympathetic chain is gained, then more refined
surgical techniques may be devised that can
minimise the rate of undesirable sequelae. Finally,
visceral cancer pain sufferers will continue to gain
excellent pain relief from targeted blocks allowing
a reduction in centrally acting drugs that can
cause sedation and confusion. However, even
this successful use of sympathetic blockade needs
further refinement and review. Improvements in
patient selection, the use of sympathetic blockade
earlier in the course of the disease and better target
identification will cement its place in the spectrum
of treatment techniques in pain medicine.
Summary
• Both sympathetic blockade and
sympathectomy have limited efficacy in the
treatment of pain syndromes.
• e variable anatomy of the sympathetic chain
produces unpredictable results in sympathetic
pain management techniques.
• Historically, specific techniques have been
developed for four main areas of interest: the
cervicothoracic ganglia, the splanchnic-coeliac
plexus, the lumbar ganglia and the superior
hypogastric plexus.
• e use of these techniques for the treatment of
cancer pain, and to some extent in peripheral
vascular disease, is undoubtedly successful.
• However, none of the techniques described
is consistently successful in the treatment of
primary hyperhidrosis or neuropathic pain
syndrome such as CRPS.
• Improvement in both technique and patient
selection may advance these treatments in the
management of sympathetic pain.
References
1. Abdalla EK, Schell S. Paraplegia following intraoperative celiac plexus injection. J Gastrointest Surg 1999;3:668–71.
2. Adson A, Brown G. e treatment of Raynaud’s disease by resection of the upper thoracic and lumbar sympathetic
ganglia and trunks. Surg Gynecol Obstet 1929;XLVIII:577–603.
3. Beglaibter N, Berlatzky Y, Zamir O, et al. Retroperitoneoscopic lumbar sympathectomy. J Vasc Surg 2002;35:815–7.
4. Benohanian A, Dansereau A, Bolduc C, et al. Localized hyperhidrosis treated with aluminum chloride in a salicylic
acid gel base. Int J Dermatol 1998;37:701–3.
5. Benson H, Friedman R. Harnessing the power of the placebo effect and renaming it “remembered wellness”. Annu Rev
Med 1996;47:193–9.
6. Black W. Use of presacral sympathectomy in treatment of dysmenorrhea. HYPERLINK “http://journals.elsevierhealth.
com/periodicals/ymob” Am J Obstet Gynecol 1964;89:16.
7. Bonica J. Causalgia and other reflex sympathetic dystrophies. In Bonica J, ed. e Management of Pain, 2nd edn.
Philadelphia: Lea & Febiger, 1990:220–43.
8. Bosscher H. Blockade of the superior hypogastric plexus block for visceral pelvic pain. Pain Practice 2001;1:162–70.
9. Bradley E, Bem J. Nerve blocks and neuroablative surgery for chronic pancreatitis. World J Surg 2003;27:1241–8.
10. Breivik H, Cousins M, Lofstrom J. Sympathetic neural blockade of upper and lower extremity. In Cousins M,
Bridenbaugh P, eds. Neural Blockade in Clinical Anesthesia and Management of Pain, 3rd edn. Philadelphia: Lippincott-
Raven, 1998:411–47.
11. Bruehl S, Harden R, Galer B, et al. External validation of IASP diagnostic criteria for complex regional pain syndrome
and proposed research diagnostic criteria. Pain 1999;81:147–54.
12. Campbell J, Raja S. Reflex sympathetic dystrophy. Neurology 1995;45:1235–7.
13. Cariati M, De Martini G, Pretolesi F, et al. CT-guided superior hypogastric plexus block. J Comput Assist Tomogr
2002;26:428–31.
14. Cartier B, Cartier P. oracoscopic cervicodorsal sympathectomy with diathermy. Ann Vasc Surg 1999;13:582–5.
15. Casale R, Elam M. Normal sympathetic nerve activity in a reflex sympathetic dystrophy with marked skin
vasoconstriction. J Auton Nerv Syst 1992;41:215–20.
16. Cepeda M, Carr D, Lau J. Local anesthetic sympathetic blockade for complex regional pain syndrome. Cochrane
Database Syst Rev 2005;4:1–9.
17. Cepeda M, Lau J, Carr D. Defining the therapeutic role of local anesthetic sympathetic blockade in complex regional
pain syndrome: A narrative and systematic review. Clin J Pain 2002;18:216–33.
18. Cervero F, Laird J. Visceral pain. Lancet 1999;353: 2145–8.
https://t.me/medicina_free
454 Philip FINCH
19. Chen SC, Lin CY, Chou MC, et al. Endoscopic thoracic sympathetic block by clipping for recurrent palmar
hyperhidrosis. Int Surg 2005;90:284–8.
20. Chou S, Kao E, Lin C, et al. e importance of classification in sympathetic surgery and a proposed mechanism for
compensatory hyperhidrosis: Experience with 464 cases. Surg Endosc 2006;20:1749–53.
21. Cousins M, Reeve T, Walsh J, et al. Neurolytic lumbar sympathetic blockade: Duration of denervation and relief of
rest pain. Anaesth Intensive Care 1979;7:121–35.
22. Cowley R, Yeager G. Anatomic observations on the lumbar sympathetic nervous system. Surgery 1949;25:880.
23. Cross F, Cotton L. Chemical lumbar sympathectomy for ischemic rest pain: A randomized, prospective controlled
clinical trail. Am J Surg 1985;150:341–5.
24. de Leon-Casasola O. Critical evaluation of chemical neurolysis of the sympathetic axis for cancer pain. Cancer Control
2000; 7:142–8.
25. de Oliveira R, dos Reis M, Prado W. e effects of early or late neurolytic sympathetic plexus block on the management
of abdominal or pelvic cancer pain. Pain 2004;110:400–8.
26. Dondelinger R, Kurdziel J. Percutaneous phenol neurolysis of the lumbar sympathetic chain with computed
tomography control. Ann Radiol (Paris) 1984;27:376–9.
27. Dondelinger R, Kurdziel J. Percutaneous phenol block of the upper thoracic sympathetic chain with computed
tomography guidance: A new technique. Acta Radiol 1987;28:511–5.
28. Drummond P, Finch P. Persistence of pain induced by startle and forehead cooling after sympathetic blockade in
patients with complex regional pain syndrome. J Neurol Neurosurg Psychiatry 2004;75:98–102.
29. Eisenberg E, Carr D, Chalmers T. Neurolytic celiac plexus block for treatment of cancer pain: A meta-analysis. Anesth
Analg 1995;80:290–5.
30. Erdine S. Transdiscal approach to the superior hypogastric plexus. Medicine Grand Rounds; 2000 June; Lubbock,
Texas: Texas Tech University Health Sciences Center.
31. Finch P. Sympathetic neurolysis. In Prithvi Raj P, ed. Textbook of Regional Anesthesia. New York: Churchill Livingstone,
2002:667–85.
32. Finch P, Racz G, McDaniel K. A curved approach to nerve blocks and radiofrequency lesioning. Pain Digest
1997;7:251–7.
33. Freeman N. e treatment of causalgia arising from gunshot wounds of the peripheral nerves. Surgery 1947;22:68–
92.
34. Furlan A, Mailis A, Papagapiou M. Are we paying a high price for surgical sympathectomy?: A systematic literature
review of late complications. ISIS Scientific Newsletter 2001;4:17–37.
35. Garcea G, omasset S, Berry D, et al. Percutaneous splanchnic nerve radiofrequency ablation for chronic abdominal
pain. Aust N Z J Surg 2005;75:640–4.
36. Gotzsche P. Is there logic in the placebo? Lancet 1994;344:925–6.
37. Hanningto-Kiff J. Sympathetic nerve blocks in painful limb disorders. In Wall P, Melzack R, eds. Textbook of Pain, 3rd
edn. Edinburgh: Churchill Livingstone, 1994:1035–52.
38. Hashim N, Wilson N. Depression accompanying compensatory hyperhidrosis following endoscopic thoracic
sympathectomy. Clin Exp Dermatol 2006;31:818–9.
39. Hassantash S, Maier R, Kaiser L, et al. Sympathectomy for causalgia: Experience with military injuries. J Trauma
2000;49:266–71.
40. Hatandgi V, Boas R. Lumbar sympathectomy: A single needle technique. Br J Anaesth 1985;57:285–9.
41. Heindel W, Ernst S, Manshausen G, et al. CT-guided lumbar sympathectomy: Results and analysis of factors
influencing the outcome. Cardiovasc Intervent Radiol 1998;21:319–23.
42. Herbst F, Plas E, Fugger R, et al. Endoscopic thoracic sympathectomy for primary hyperhidrosis of the upper limbs :
A critical analysis and long-term results of 480 operations. Ann Surg 1994;220:86–90.
43. Hughes J. Endothoracic sympathectomy. Proc R Soc Med 1942;35:585–6.
44. Ina H, Kitoh T. A new approach to superior hypogastric nerve block: Transvertebral disk L5–S1 technique. Reg Anesth
1992;17:123.
45. Ischia S, Ischia A, Polati E, et al. ree posterior percutaneous celiac plexus block techniques: A prospective, randomized
study in 61 patients with pancreatic cancer pain. Anesthesiology 1992;76:534–40.
46. I
schia S, Polati E, Finco G, et al. Celiac block for the treatment of pancreatic pain. Curr Rev Pain 2000;4:127–33.
47. Jaboulay M. Le traitment de la nevralgie pelviene par paralyse due sympathique sacre. Lyon Medical 1899;90:102.
48. Jadad A, Carroll D, Glynn C, et al. Intravenous regional sympathetic blockade for pain relief in reflex sympathetic
dystrophy: A systematic review and a randomized, double-blind crossover study. J Pain Symptom Manage 1995;10:13–
20.
49. Janig W. e puzzle of reflex sympathetic dystrophy: Mechanisms, hypothesis, open questions. In Janig W, Stanton-
Hicks M, eds. Reflex Sympathetic Dystrophy: A Reappraisal. Seattle: IASP Press, 1996:1–24.
50. Kanazi G, Perkins F, akur R, et al. New technique for superior hypogastric plexus block. Reg Anesth Pain Med
1999;24:473–6.
https://t.me/medicina_free
455
The Sympathetic Chain
51. Kapural L, Mekhail N. Assessment of sympathetic blocks. Tech Reg Anesth Pain Manage 2001;5:82–7.
52. Kargar S, Yasini M, Ayatollahi V. oracic sympathectomy in social phobia: A pilot study. Internet J Surg 2006;7.
53. Katritsis ED, Lykaki-Anastopoulou G, Papadopoulos N. e relations of the superior pole of the stellate ganglion to
the vertebral artery. Anat Anz 1981;150:259–63.
54. Koman L, Smith B, Pollock FJ, et al. e microcirculatory effects of peripheral sympathectomy. J Hand Surg
1995;20A:709–17.
55. Kotzareff A. Resection partielle de tronc sympathetique cervical droit pour hyperhidrose unilaterale. Rev Med Suisse
Romande 1920;40:111–3.
56. Kux E. orakoskopische Eingriffe am Nervensystem. Stuttgart: Gerog ieme Verlag, 1954.
57. Kux M. oracic endoscopic sympathectomy in palmar and axillary hyperhidrosis. Arch Surg 1978;113:264–6.
58. Kwong K, Cooper L, Bennett L, et al. Clinical experience in 397 consecutive thoracoscopic sympathectomies. Ann
orac Surg 2005;80:1063–6.
59. Lee A, Agarwal S, Sadhu D. A 7-year experience with thoracoscopic sympathectomy for critical upper limb ischemia.
World J Surg 2006;30:1644–7.
60. Leriche R. De le longation et de la section des nerfs perivasculaires dans certains syndromes douloureux d’origine
arterielle et dans quelques troubles trophiques. Lyon Chirurgical 1913;X:378.
61. Leriche R. De la causalgie envisagée comme une névrite du sympathique et de son traitement par la dénudation et
l’excision des plexus nerveux péri-arteriels. La Presse Médicale 1916;24:178–280.
62. Leriche R. e Surgery of Pain. London: Bailliere, Tindall and Cox, 1939.
63. Lyons A, Mills C. Anatomical variants of the cervical sympathetic chain to be considered during neck dissection. Br J
Oral Maxillofac Surg 1998;36:180–2.
64. Mailis-Gagnon A, Furlan A. Sympathectomy for neuropathic pain. Cochrane Database Syst Rev 2002;1:1–18.
65. McAllister R, Carpentier B, Malkuch G. Sacral postherpetic neuralgia and successful treatment using a paramedial
approach to the ganglion impar. Anesthesiology 2004;101:1472–4.
66. McKay W, McKay R. Neurolytic celiac plexus block for benign pain: Still a question? Reg Anesth Pain Med 2003;28:495–
7.
67. Mercadante S, La Rosa S, Villari P. CT-guided neurolytic splanchnic nerve block by an anterior approach. J Pain
Symptom Manage 2002;23:268–70.
68. Mitchell S, Moorehouse G, Keen W. Gunshot Wounds and Other Injuries of Nerves. Philadelphia: JB Lippincott,
1864.
69. Moore D. Celiac (splanchnic) plexus block with alcohol for cancer pain of the upper intra-abdominal viscera. In
Bonica J, Ventafridda V, eds. Advances in Pain Research and erapy. New York: Raven Press, 1979:357–71.
70. Munir M, Zhang J, Ahmad M. A modified needle-inside-needle technique for the ganglion impar block. Can J Anaesth
2004;51:915–7.
71. Navarro-Martinez J, Montes A, Comps O, et al. Retroperitoneal abscess after neurolytic celiac plexus block from the
anterior approach. Reg Anesth Pain Med 2003;28:640–4.
72. Nebab E, Florence I. An alternative needle geometry for interruption of the ganglion impar. Anesthesiology
1997;86:1213–4.
73. Neumayer C, Bischof R, Fugger M, et al. Efficacy and safety of thoracoscopic sympathicotomy for hyperhidrosis of the
upper limb: Results of 734 sympathicotomies. Ann Chir Gynaecol 2001;90:195–9.
74. Neumayer C, Panhofer P, Zacherl J, et al. Effect of endoscopic thoracic sympathetic block on plantar hyperhidrosis.
Arch Surg 2005;140:676–80.
75. Noe C, Haynsworth R. Lumbar radiofrequency sympatholysis. J Vasc Surg 1993;17:801–6.
76. Oh C, Chung I, Ji H, et al. Clinical implications of topographic anatomy on the ganglion impar. Anesthesiology
2004;101:249–50.
77. Ojimba T, Cameron A. Drawbacks of endoscopic thoracic sympathectomy. Br J Surg 2004;91:264–9.
78. Panhofer P, Zacherl J, Jakesz R, et al. Improved quality of life after sympathetic block for upper limb hyperhidrosis. Br
J Surg 2006; 93:582–6.
79. Perlow S, Vehe K. Variations in the gross anatomy of the stellate and lumbar sympathetic ganglia. Am J Surg
1935;30:454.
80. Plancarte R, Amescua C, Patt R, et al. Superior hypogastric plexus block for pelvic cancer pain. Anaesthesiology
1990;73:236–9.
81. P
lancarte R, de Leon-Casasola O, El-Helaly M, et al. Neurolytic superior hypogastric plexus block for chronic pelvic
pain associated with cancer. Reg Anesth 1997;22:562–8.
82. Polati E, Finco G, Gottin L, et al. Prospective randomized double-blind trial of neurolytic coeliac plexus block in
patients with pancreatic cancer. Br J Surg 1998;85:199–201.
83. Raj P, omas J, Heavner J, et al. e development of a technique for radiofrequency lesioning of splanchnic nerves.
Curr Rev Pain 1999;3:377–87.
https://t.me/medicina_free
456 Philip FINCH
84. Raj PP, ed. Textbook of Regional Anesthesia. New York: Churchill Livingstone, 2002.
85. Redman D, Robinson P, Al-Kutoubi M. Computerised tomography guided lumbar sympathectomy. Anaesthesia 1986;
41:39–41.
86. Reisfeld R, Nguyen R, Pnini A. Endoscopic thoracic sympathectomy for hyperhidrosis: Experience with both
cauterization and clamping methods. Surg Laparosc Endosc Percutan Tech 2002;12:255–67.
87. Richards R. Causalgia: A centennial review. Arch Neurol 1967;16:339–50.
88. Rocco A, Palombi D, Raeke D. Anatomy of the lumbar sympathetic chain. Reg Anesth 1995;20:13–9.
89. Rosenthal J. Diaphragmatic paralysis complicating alcohol splanchnic nerve block. Anesth Analg 1998;6:845–6.
90. Ross J. Sympathectomy as an experiment in human physiology. Br J Surg 1933;21:5–19.
91. Royle N. e treatment of spastic paralysis by sympathetic ramisection. Surg Gynecol Obstet 1924;XXXIX:701–20.
92. Royle N. e surgical treatment of Raynaud’s disease and similar conditions. Med J Aust 1927;XI(Suppl.):341–3.
93. Ruggi G. Sympathectomia al collo ed ale abdome. Policlinoico 1899:103.
94. Schick C, Horbach T. Sequelae of endoscopic sympathetic block. Clin Auton Res 2003;13(Supp1):136–9.
95. Scholing A, Emmelkamp P. Treatment of fear of blushing, sweating, or trembling. Results at long-term follow-up.
Behav Modif 1996;20:338–56.
96. Schott G. Interrupting the sympathetic outflow in causalgia and reflex sympathetic dystrophy. BMJ 1998;316:792–
3.
97. Shumacker H, Kilman J. Sympathectomy in the treatment of frostbite. Arch Surg 1964;89:575–84.
98. Stanton-Hicks M, Janig W, Hassenbusch S, et al. Reflex sympathetic dystrophy: Changing concepts and taxonomy.
Pain 1995;63:127–33.
99. Strandness D, Bell J. Critical evaluation of the results of lumbar sympathectomy. Ann Surg 1963;160:1021–9.
100. Telaranta T. Treatment of social phobia by endoscopic thoracic sympathicotomy. Eur J Surg 1998;164(Suppl 580):27–
32.
101. une T, Ladegaard L, Licht P. oracoscopic sympathectomy for Raynaud’s phenomenon: A long-term follow-up
study. Eur J Vasc Endovasc Surg 2006;32:198–202.
102. Turker G, Basagan-Mogol E, Gurbet A, et al. A new technique for superior hypogastric plexus block: e posteromedian
transdiscal approach. Tohoku J Exp Med 2005;206:277–81.
103. Uhde T, Tancer M, Black B, et al. Phenomenology and neurobiology of social phobia: Comparison with panic disorder.
J Clin Psychiat 1991;52(Suppl):31–40.
104. Umeda S, Arai T, Halano Y, et al. Cadaver anatomic analysis of the best site for chemical lumbar sympathectomy.
Anesth Analg 1987;66:643–6.
105. Waldman S, Wilson W. Superior hypogastric plexus block using a single needle and computed tomographic guidance:
Description of a modified technique. Reg Anesth 1991;16:286–7.
106. Waldman SD, ed. Interventional Pain Management, 2nd edn. Philadelphia: WB Saunders, 2001.
107. Wallin B, Torebjork H, Hallin R. Preliminary observations on the pathophysiology of hyperalgesia in the causalgic
pain syndrome. In Zotterman Y, ed. Sensory Function of the Skin. New York: Pergamon, 1976:489–99.
108. Wang P, Shang M, Qian Z, et al. CT-guided percutaneous neurolytic celiac plexus block technique. Abdom Imaging
2006; 31:710-8.
109. Wang W, Lai C, Chang K, et al. Peripheral sympathectomy for Raynaud’s phenomenon: A salvage procedure. Kaohsiung
J Med Sci 2006;22:491–9.
110. Ward E, Rorie D, Nauss L, et al. e celiac ganglia in man: Normal anatomic variations. Anesth Analg 1979;58:461–
5.
111. Wemm K, Saberski L. Modified approach to block the ganglion impar (ganglion of Walther). Reg Anesth 1995;20:544–
5.
112. Weyland A, Weyland W, Carduck H, et al. Which paravertebral approach is optimal for lumbar sympathetic blocks?
Results of computer tomographic simulation studies. Pain 1990;5(Suppl):489.
113. Wilkinson H. Stereotactic radiofrequency sympathectomy. Pain Clinic 1995;8:107–15.
114. W
ilkinson H. Percutaneous radiofrequency upper thoracic sympathectomy. Neurosurgery 1996;38:715–25.
115. Williams P, ed. Gray’s Anatomy, 38th edn. New York: Churchill Livingstone, 1995:1297,1303–4,1793.
116. Wong G, Schroeder D, Carns P, et al. Effect of neurolytic celiac plexus block on pain relief, quality of life, and survival
in patients with unresectable pancreatic cancer: A randomized controlled trial. JAMA 2004;291:1092–9.
117. Yamamuro M, Kusaka K, Kato M, et al. Celiac plexus block in cancer pain management. Tohoku J Exp Med
2000;192:1–18.
118. Yeo S, Chong J. A case report on the treatment of intractable anal pain from metastatic carcinoma of the cervix. Ann
Acad Med Singapore 2001; 30:632–3.
119. Yilmaz E, Dur A, Cuesta M, et al. Endoscopic versus transaxillary thoracic sympathectomy for primary axillary and
palmar hyperhidrosis and/or facial blushing: 5-year experience. Eur J Cardiothorac Surg 1996;10:168–72.
https://t.me/medicina_free
457
The Sympathetic Chain
120. Yin W. Posterior parasagittal approach to thoracic paravertebral neural structures with curved cannulae: Methodology
and technique to decrease the incidence of unintentional visceral injury with thoracic percutaneous approaches for the
treatment of chronic pain. ISIS Scientific Newsletter 2000;4:18–40.
121. Zacherl J, Huber E, Imhof M, et al. Long-term results of 630 thoracoscopic sympathicotomies for primary hyperhidrosis:
e Vienna experience. Eur J Surg 1998;(Suppl 580):43–6.
https://t.me/medicina_free
https://t.me/medicina_free
Introduction
Both neck and back pain are very common complaints in
many communities. More than half of the population in the
United States suffers from low back pain at some time; the
annual incidence is at least 5%. Back pain incapacitates up
to 20% of workers for long period (>4 weeks), absorbs 41%
of the cost of workers’ compensation and costs society more
than $15 million each year [1, 7, 24]. A similar situation exists
elsewhere, including Hong Kong [26]. However, the cause can
be very diverse, ranging from simple neck and back sprain to
some less well-known causes such as facet joint arthritis and
sacroiliitis. Although 90% of low back pain resolves after 6
weeks and another 5% after 12 weeks, about 5% will advance
from an acute to a chronic condition, if we ignore the patient’s
complaints. Without proper care, some patients will progress
to chronic back or neck pain. In order to determine the true
pathology of the patient’s symptoms, it is necessary to take a
proper history and examine meticulously to find the underlying
mechanisms of pain production. Sometimes, more than one
pain generator can be present in the same patient. Referred
pain should also be excluded before a definitive diagnosis is
made. For example, renal or aortic pathology can also give
rise to symptoms similar to low back pain. is chapter will
discuss the interventional management of back and neck
pain associated with skeletal causes. Pain related to muscle
conditions are discussed in Chapter 14. Once the underlying
pathophysiology is found, appropriate intervention can take
place to alleviate the patient’s suffering.
Epidural Steroid Injection
Epidural steroid injection has been used for back pain caused
by annulus tear, chronic lumbar degenerative disc disease,
Interventional Procedures for Back
and Neck Pain
28
Kai On SUN, Henry Ka Fai TONG
INTRODUCTION
EPIDURAL STEROID INJECTION
SLEEVE ROOT INJECTION
FACET JOINT SYNDROME AND ITS
INTERVENTION
SACROILIAC JOINT PAIN AND ITS
INTERVENTION
DISCOGENIC BACK PAIN AND ITS
INTERVENTION
EPIDUROSCOPY AND
EPIDUROLYSIS
VERTEBROPLASTY AND
KYPHOPLASTY
CONCLUSION
REFERENCES
https://t.me/medicina_free
Соседние файлы в папке Библиотека им академика М.И. Перельмана