Chemical Lumbar Sympathetic Block in the Treatment of Plantar Hyperhidrosis

Abstract

BACKGROUND Plantar hyperhidrosis is a distressing problem that can affect a patient's quality of life. Although various conservative modalities have been suggested, severe plantar hyperhidrosis is often not sufficiently treated. OBJECTIVE The aim of this study was to evaluate the safety and the effectiveness of a chemical lumbar sympathetic block (CLSB) with alcohol in patients with severe plantar hyperhidrosis. METHOD Sixty-nine patients were treated by a neurolytic lumbar block. A single-needle or two-needle technique was used with patients in the prone position. RESULTS Of 138 procedures, the number of successful blocks was 68 (49.3%) for L3 to L4 and 28 (20.3%) for L4 to L5. The degree of anhydrosis was excellent in 6 patients (8.7%), good in 32 patients (46.4%), fair in 32 patients (34.8%), and poor in 7 patients (10.1%). Of 69 patients, 56 (81.1%) were partially or fully satisfied. Noted complications included temporary sexual dysfunction in 1 patient, compensatory hyperhidrosis in 1 patient, and transient genitofemoral neuritis in 3 patients. Although 62 patients (89.9%) recurred at 6 to 18 months, 3 patients (4.3%) remained stable until 18 to 24 months. CONCLUSION The careful use of CLSB on an outpatient basis can be a safe, minimally invasive, and effective treatment for severe plantar hyperhidrosis.