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Updated: Jul 10, 2026

Targeting Gray Rami Communicantes in Selective Chemical Lumbar Sympathectomy
Published on: January 10, 2019
Lumbosacral plexus lesions
G Stevanato1, L Vazzana, S Daramaras
1Department of Neurosurgery, Umberto I Hospital, Mestre-Venezia, Italy. giorgio.stevanato@ulss12.ve.it
Background:
Aim of the present study was to analyse the main causes of lumbosacral plexus lesions together with the best diagnostic and therapeutic options for better patient outcome.
Methods:
We report our surgical experience with eight patients in whom lesion mechanisms consisted of high-energy trauma (4 pts), firearm injuries (2 pts), spontaneous retroperitoneal haematoma in anticoagulant therapy (1 pt) and schwannoma (1 pt). The diagnosis was not straightforward and included clinical aspects, electrophysiological studies, magnetic resonance and CT myelography. Surgery was performed by lateral extraperitoneal approach for the lumbar plexus, transperitoneal approach on the midline to reach the sacral plexus, and neuronavigation was used in the schwannoma case.
Conclusions:
Lumbosacral plexus lesions require a challenging multidisciplinary approach to diagnose and treat; the outcome, even if delayed, was very encouraging. In all our patients pain was controlled, and six patients returned to unaided walking.
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