Cadaver Anatomic Analysis of the Best Site for Chemical Lumbar Sympathectomy

Abstract

The lumbar sympathetic ganglia and their surroundings were examined anatomically in 19 human cadavers. The locations of the ganglia on the lumbar vertebral column at the level of the second and third lumbar vertebral bodies were analyzed statistically using a “ganglion score”. The ganglia were most frequently found at the level of the lower third of the second lumbar vertebra, at the L2–3 interspace, and at the level of the upper third of the third lumbar vertebra on both the right and left sides. The points at which the sympathetic chain and the lumbar arteries crossed were at the middle third of the vertebral body in both the second and third lumbar vertebra. These results suggest that the most suitable point for placement of the tip of the needle used for chemical lumbar sympathectomy is not the midpoint of a vertebral body, but rather the lower third of the second vertebral body or the upper third of the third vertebral body.