Sympathectomy for causalgia. Patient selection and long-term results
M. B. Mockus, R. B. Rutherford, C. Rosales and W. H. Pearce
Thirty-four sympathectomies were performed for causalgic pain. Overt
extremity trauma was the precipitating event in only 26%. In 48%, nerve
compression requiring surgical relief preceded the onset of the pain; most
common lumbar disk surgery (37%). In the remainder (26%), miscellaneous
vascular conditions contributed. Satisfactory immediate relief was obtained
in 97% and 61% were completely relieved of pain initially. There were no
deaths, 10% wound complication rate, and one instance of Horner's syndrome.
Postsympathectomy neuralgia occurred in close to 40%, lasted a little over
a month on the average but did not persist beyond ten weeks. In extended
follow-up, only one patient failed to sustain satisfactory relief (97% of
those relieved, 94% of the total) and 84% continued to enjoy the same
degree of relief as they had immediately preoperatively. This frequency,
degree, and duration of benefit establishes causalgic pain as one of the
best indications for surgical sympathectomy.
