Lumbar Sympathectomy
Lumbar Sympathectomy is a minimally invasive, image-guided procedure performed by Interventional Radiologists (IRs) to improve blood flow to the legs.
Lumbar Sympathectomy
Lumbar Sympathectomy is a minimally invasive, image-guided procedure performed by Interventional Radiologists (IRs) to improve blood flow to the legs. It involves blocking or removing part of the sympathetic nerves that control blood vessel constriction, and can form part of the treatment paradigm for chronic limb threatening ischaemia (CLTI). This can help relieve pain and improve circulation in patients with severe peripheral arterial disease who are not suitable for further surgical or endovascular treatment.
Lumbar Sympathectomy is also referred to as Chemical Lumbar Sympathectomy, Lumbar Sympatholysis, and Lumbar Sympathetic Neurolysis.
The Procedure
The procedure is performed under X-ray or CT guidance, usually with a local anaesthetic and procedural sedation. A fine needle is advanced to the area of the sympathetic nerves alongside the lumbar spine. The nerves can then be treated using either a chemical injection (neurolytic agent) or heat energy (radiofrequency ablation). This modulates the nerve signals that contribute to narrowing of blood vessels in the legs, reducing vascular tone and improving blood flow. Lumbar sympathectomy also modulates pain signals, typically reducing pain associated with CLTI. The procedure usually takes less than an hour, and patients are observed for a short time afterwards before returning home the same day.
Benefits
Lumbar Sympathectomy is a minimally invasive treatment that can improve blood flow and reduce rest pain in the legs. It may help avoid or delay the need for major surgery or amputation in patients with advanced vascular disease where other options are limited.
Risks
The procedure is considered safe, but as with any intervention there are potential risks. Minor side effects can include temporary back pain or bruising at the needle site. Rare but more significant complications may include bleeding, infection, or damage to nearby structures such as blood vessels or nerves. Your Interventional Radiologist will discuss these risks with you before the procedure.
Aftercare
Most patients recover quickly and can walk shortly after the procedure. Mild back discomfort is common for a few days and can be managed with simple pain relief. Improvement in leg pain and circulation is usually noticed gradually over days to weeks. Regular follow-up with your vascular specialist and Interventional Radiologist will help monitor your progress.
Specialist Care
At Specialist IR, Lumbar Sympathectomy is performed by experienced Interventional Radiologists in both public and private hospitals across Melbourne, Victoria. Eligible public patients may undergo the procedure with no out-of-pocket costs. Referrals should include clinical history and relevant imaging to allow our team to assess suitability and plan the best treatment.
Preparation and Referral
If you would like to refer to an Interventional Radiologist for consideration of image guided lumbar sympathectomy, please send a referral for consultation, including the following;
• Available recent imaging and blood tests
• Surgical history, inclusive of any recent angiograms or vascular surgical procedures
• Records of consultation with vascular medical or surgical specialists
Lumbar Sympathectomy procedures are performed at most of our public and private hospital locations in Melbourne, Victoria, Australia.
Lumbar Sympathectomy content by Dr James Lisik.