The purpose of this study was to assess the effectiveness of chemical lumbar
sympathectomy in relieving
pain and healing ischaemic
ulcers in patients with
peripheral vascular diseases. Thirty-one consecutive patients with ischaemic/ gangrenous lower limb
ulcers, referred to the BPKIHS, Pain Clinic were observed prospectively after chemical lumbar
sympathectomy using modified Reid Technique with 3 ml of 70% alcohol each at L2 and L3 level under fluoroscopic guidance.
Pain relief and
ulcer healing were noted in the follow up. Moreover, patients' abilities to resume at least part of their day to day work were also noted at three months follow up. Of the total 31 patients, 16 had
Buerger's disease and the remaining 15 had non-Buerger's ischaemic
ulcers of which 7 were diabetic. There was significant decrease in the
pain score from mean+/-SD of 8.3+/-0.9 (pre-block) to 4.2+/-2.5 (post-block after 3 days) in zero to 10 Numerical Analogue Scale (
NAS). By 3 months, 6 patients declined for follow up; 19(76%) of the remaining 25 patients reported
pain relief, 18(72%) reported healing or decrease in the size of
ulcers and 11(44%) were able to resume at least part of their usual work. Minor complications occurred in 5 patients and
amputation was needed in 6 patients. Fluoroscopy- guided chemical lumbar
sympathectomy is feasible, safe and effective in relieving
pain and promoting
ulcer healing in patients with ischaemic lower limb
ulcers due both to
Buerger's disease and non-Buerger's
peripheral vascular diseases.