The amount of compensatory sweating depends on the patient, the damage that the white rami communicans incurs, and the amount of cell body reorganization in the spinal cord after surgery.
Other potential complications include inadequate resection of the ganglia, gustatory sweating, pneumothorax, cardiac dysfunction, post-operative pain, and finally Horner’s syndrome secondary to resection of the stellate ganglion.
www.ubcmj.com/pdf/ubcmj_2_1_2010_24-29.pdf

After severing the cervical sympathetic trunk, the cells of the cervical sympathetic ganglion undergo transneuronic degeneration
After severing the sympathetic trunk, the cells of its origin undergo complete disintegration within a year.
http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0442.1967.tb00255.x/abstract

Thursday, January 17, 2008

Sympathectomy for sympathetically mediated pain

Surgical sympathectomy, spinal cord stimulation, and central
neuraxial blockade have all been reported to be useful, but not rigorously tested. When superficial tactile
allodynia is a prominent feature of the patient’s presentation, this author has found that a diagnostic
lumbar paravertebral sympathetic block can be useful in assessing the degree of sympathetically mediated
pain. When sympathetically mediated pain is a prominent feature, as evidenced by over 50% pain reduction
with the sympathetic block, a percutaneous radiofrequency rhizotomy of the sympathetic chain can follow
for a more long-lasting effect.

By Timothy L. Sternberg, DMD, MD
Director, Center for Pain Management
University of Florida/Shands Jacksonville