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Sympathetic Blockade of the Spine 

Sympathetic Blockade of the Spine
Sympathetic Blockade of the Spine

John M. DiMuro

, and Mehul J. Desai

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date: 05 March 2021

This chapter focuses on the typical pain complaints and their appropriateness for sympathetic blockade and neurolysis. Anatomic considerations, block technique, associated risks, and evidence of a successful block are covered for the stellate ganglion block, T2 sympathetic block, thoracic splanchnic block, celiac plexus block, superior hypogastric plexus block, and ganglion of impar block. Sympathetic blockade is commonly used for visceral pain syndromes. Visceral pain syndromes typically are not responsive to neuraxial blocks as well as conventional rehabilitative and pharmacologic treatments. Spinal sympathetic techniques involve careful prevertebral needle placement, typically using fluoroscopic guidance. The proximity of major vessels near the target injection area is the primary risk of these techniques. In general, sympathetic blocks are non-diagnostic, but they can still help determine whether a sympathetically mediated pain condition may be present and if sympatholysis may be an effective treatment option.

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