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Lumbar Sympathetic Block and Neurolysis: Computed Tomography 

Lumbar Sympathetic Block and Neurolysis: Computed Tomography
Chapter:
Lumbar Sympathetic Block and Neurolysis: Computed Tomography
Source:
Multimodality Imaging Guidance in Interventional Pain Management
Author(s):

Bruno Kastler

and Adrian Kastler

DOI:
10.1093/med/9780199908004.003.0031

Lumbar sympathetic block and neurolysis are accepted treatment procedures in patients with sympathetic mediated lower limb pain and patients with advanced peripheral arterial disease. The use of imaging guidance is highly recommended in order to achieve best possible results and to avoid complications. The high image resolution (as opposed to fluoroscopy) and high availability (as opposed to MRI) offered by CT makes it the imaging guidance technique preferred. This chapter reviews the indications of lumbar sympathetic chain blockade and neurolysis and the basic anatomical background. Then it demonstrates how CT guidance allows a step-by-step control of positioning the needle tip at the target for either lumbar blockade or alcohol neurolysis and the advantages and disadvantages of each technique are summarized.

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