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Lumbar sympathectomy for lower extremity vasospasm.

K A Janoff, E S Phinney, J M Porter

    American Journal of Surgery
    |July 1, 1985
    PubMed
    Summary

    Lumbar sympathectomy effectively treats refractory lower extremity vasospasm. This surgical intervention provided durable relief for patients unresponsive to other treatments, offering a long-term solution for this condition.

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    Area of Science:

    • Vascular Surgery
    • Peripheral Vascular Diseases
    • Neurology

    Background:

    • Refractory episodic lower extremity vasospasm is a challenging condition.
    • Over 600 upper extremity vasospasm cases were studied, identifying 10 lower extremity cases.

    Purpose of the Study:

    • To evaluate the efficacy of lumbar sympathectomy for refractory episodic lower extremity vasospasm.
    • To identify diagnostic patterns and treatment outcomes for this condition.

    Main Methods:

    • Case series of 10 patients with refractory episodic lower extremity vasospasm.
    • Diagnostic toe photoplethysmography (normal after warming, flat after cooling).
    • Treatment included reserpine Bier block and lumbar sympathectomy.

    Main Results:

    • Reserpine Bier block provided temporary relief (1-3 days).
    • Oral medications were ineffective.
    • All patients undergoing lumbar sympathectomy remained free of vasospasm for an average of 4 years.

    Conclusions:

    • Lumbar sympathectomy is an effective and durable treatment for lower extremity vasospasm.
    • Photoplethysmography can aid in diagnosis.
    • This surgical approach offers lasting symptom resolution.

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