Article
Neurosurgery Quarterly. 12(2):89-99, June 2002.Wilkinson, Harold A.
Abstract:
Summary: Surgical resections of sympathetic ganglia from the thoracic, splanchnic, and lumbar area have been carried out for more than 100 years. In the past decade, neurosurgeons have become more interested in surgery on the sympathetic nervous system as less invasive techniques have been developed. Percutaneous radiofrequency and video-assisted endoscopic techniques have largely replaced open surgical thoracic sympathectomy. Lumbar and splanchnic sympathetic ablation is commonly done by percutaneous chemical techniques or, occasionally, by radiofrequency ablation, but the open techniques are still widely used. Sympathectomy is most widely employed for pathologic hyperhidrosis (especially the palmar component), sympathetically maintained pain, and vasospastic or ischemic vascular disease. The less invasive techniques are especially attractive for treating the sympathetically mediated cardiac diseases, including Prinzmetal angina, "syndrome X," and congenital long Q-T interval syndrome.
Surgical complications are usually manageable, but deaths have occurred (even with endoscopic techniques).
