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Cervical Sympathetic Block and Neurolysis: Computed Tomography 

Cervical Sympathetic Block and Neurolysis: Computed Tomography
Cervical Sympathetic Block and Neurolysis: Computed Tomography
Multimodality Imaging Guidance in Interventional Pain Management

Adrian Kastler

and Bruno Kastler


The stellate ganglion blockade technique is used to treat complex regional pain syndrome (CRPS). It is now well established that stellate blockades should be performed under imaging guidance. It has been suggested that alcohol may bring longer lasting relief in cases of severe intractable cancer-related pain arising from regional neoplasms invading the stellate ganglion, but frequent onset of Horner’s syndrome can outweigh the technique’s efficacy. Radiofrequency neurolysis (RFN) has become a common procedure in the management of chronic neuropathic pain. This chapter reviews indications of stellate ganglion procedures and describes the basic anatomical background, as knowledge of the anatomical surroundings of the stellate ganglion is a necessary prerequisite to a safe and successful procedure. Then it demonstrates how CT-guidance allows a step-by-step control of positioning the needle tip at target for either alcohol or radiofrequency thermal ablation, and discusses the results, advantages, and disadvantages of each approach.

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