Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD
BACKGROUND: Lumbar sympathetic plexus (LSP) has been described as a target for managing chronic pain with a sympathetic component in the lower limbs such as complex regional pain syndrome (CRPS) or pain of ischemic origin. LSP neurolysis with phenol or ethanol has been applied; more recently, radiofrequency (RF) lesioning has been proposed as an alternative. RF denervation has the advantage of avoiding the complications associated with ethanol/phenol spread.
CASE REPORT: We describe 2 cases in which RF denervation of LSP was performed in patients suffering from chronic pain from CRPS and chronic ischemic disease of the lower limb.
CONCLUSION: RF denervation of LSP could be considered as a treatment for CRPS and chronic ischemic pain when conventional medical therapy fails. Compared to chemical neurolysis, RF denervation carries less risk for postprocedural deafferentation pain.
KEY WORDS: Complex regional pain syndrome; ischemic pain; lumbar sympathetic plexus; neurolysis; radiofrequency; sympathetically maintained pain