The amount of compensatory sweating depends on the patient, the damage that the white rami communicans incurs, and the amount of cell body reorganization in the spinal cord after surgery.
Other potential complications include inadequate resection of the ganglia, gustatory sweating, pneumothorax, cardiac dysfunction, post-operative pain, and finally Horner’s syndrome secondary to resection of the stellate ganglion.
www.ubcmj.com/pdf/ubcmj_2_1_2010_24-29.pdf

After severing the cervical sympathetic trunk, the cells of the cervical sympathetic ganglion undergo transneuronic degeneration
After severing the sympathetic trunk, the cells of its origin undergo complete disintegration within a year.
http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0442.1967.tb00255.x/abstract

Tuesday, January 20, 2009

Alterations of the Three-Phase Bone Scan After Sympathectomy

The data demonstrated that alterations in TPBS after sympathectomy are identical to those reported in early RSD and these alterations bear no relationship to the success of sympathectomy regarding pain relief. The mechanisms underlying alterations of TPBS as well as the potential mechanisms of sympathectomy failures are discussed.

Clinical Journal of Pain. 10(2):146-155, June 1994

sympathectomy is based on poor quality evidence, uncontrolled studies and personal experience

The practice of surgical and chemical sympathectomy is based on poor quality evidence, uncontrolled studies and personal experience. Furthermore, complications of the procedure may be significant, in terms of both worsening the pain or producing a new pain syndrome; and abnormal forms of sweating (compensatory hyperhidrosis and pathological gustatory sweating). Therefore, more clinical trials of sympathectomy are required to establish the overall effectiveness and potential risks of this procedure.
Cochrane Database Syst Rev. 2003;(2):CD002918.Click here to read

Painful sweating after nerve sprouting

The authors propose that after destruction of cutaneous nerves, aberrant regenerant sprouting innervates sweat glands, producing gustatory sweating as in auriculotemporal syndrome (Frey syndrome), and innervates nociceptors, producing pain.

http://www.neurology.org/cgi/content/abstract/63/8/1471

Sexual function after bilateral lumbar sympathectomy

In patients who had only bilateral sympathectomy, these complications occurred in 24% and mainly consisted of ejaculation disturbances. Only three patients became impotent, each having had aortic surgery.

http://www.ncbi.nlm.nih.gov/pubmed/7364866
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