PHYSIOLOGIC EFFECTS OF THORACIC AND OF LUMBAR SYMPATHETIC GANGLIONECTOMY OR SECTION OF THE TRUNK

Abstract

The permanent vasomotor and other physiologic changes resulting from sympathetic lumbar ganglionectomy with ramisectomy or section of the trunk have stimulated investigation and clinical application. We first studied a group of patients with spastic paralysis and subsequently a group with vascular disturbances of the vasoconstrictor type, that is, Raynaud's disease, other vascular diseases such as thrombo-angiitis obliterans, scleroderma and, in one case, subacute polyarthritis. This report includes the preoperative and postoperative physiologic studies on a total of thirty-nine cases. ANATOMY AND PHYSIOLOGY † Ranson 1 summarized the anatomy of the sympathetic nervous system as follows: The sympathetic nervous system is an aggregation of ganglions, nerves, and plexuses through which the viscera, glands, heart, blood vessels and smooth muscle in other situations receive their innervation. The most conspicuous feature of the system is a pair of ganglionated nerve cords or sympathetic trunks, which extend vertically through the neck, thorax and abdomen.