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

Monday, June 4, 2012

Bilateral lumbar sympathectomies carry a risk of impotence

           Contraindications. Prior contralateral sympathectomy, significant cardiovascular disease, or autonomic nervous system insufficiency.
           Post-operative course. Mild-moderate post-operative pain, usually lasting less than 2 weeks.
           Results. Sympathetic blocks and sympathectomies may provide significant relief in 60% of patients who undergo them (19-23). The mechanism on which this relief is based is open to question. There may be a significant placebo effect influencing the response to sympathetic blocks (18, 19). Mean time to pain recurrence following sympathectomy is six months (23).
           Benefits. Several months of sympatholysis from a safe, repeatable, outpatient procedure, which doesn't cause local fibrosis, rendering subsequent retroperitoneal surgery difficult.
           Risks. There are various risks associated with sympathectomy. These risks are minimized through the use of CT imaging, careful needle placement, and utilizing RF instead of chemical neurolysis.
           The major risks of radiologically guided sympathectomies include pnemothorax, inadvertent damage to the genitofemoral nerve in the lumbar area, and inadvertent root trauma. Transient hypotension may follow sympathetic blocks and sympathectomies. Bilateral cervical sympathectomies should be avoided because of the destruction of cardioaccelerator tone. Bilateral lumbar sympathectomies carry a risk of impotence.
http://www.hiesiger.com/physicians/physicianrfl.html