Human lumbar sympathetic blockade: An anatomical study to address potential block failure.
anatomical dissection
complex regional pain syndrome
fluoroscopic control
lumbar sympathetic block
Journal
Clinical anatomy (New York, N.Y.)
ISSN: 1098-2353
Titre abrégé: Clin Anat
Pays: United States
ID NLM: 8809128
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
revised:
16
07
2022
received:
12
06
2022
accepted:
20
07
2022
pubmed:
24
7
2022
medline:
11
3
2023
entrez:
23
7
2022
Statut:
ppublish
Résumé
The lumbar sympathetic block is often used to treat complex regional pain syndrome, but it seems to have a high failure rate. This study seeks anatomical explanations for this apparent failure in order to refine our block procedure. Two simulated sympathetic trunk blocks were carried out on four fresh, cryopreserved unembalmed human cadavers under fluoroscopic control at the L2 vertebral body level, followed by two further simulated blocks at the L4 vertebral body level on the other side. Dye was injected, and the areas were dissected following a specific protocol. We then describe the anatomy and the spread of the dye compared to the spread of the contrast medium on fluoroscopy. The ganglia were differently located at different vertebral levels, and differed among the cadavers. Following this anatomical clarification, we now prefer to perform lumbar sympathetic blocks at the fourth lumbar vertebra level, using an extraforaminal approach at the caudal end of the vertebra, avoiding the anterolateral margin of the vertebral body at the midpoint.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
360-371Informations de copyright
© 2022 American Association of Clinical Anatomists and British Association of Clinical Anatomists.
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