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Anesth Analg 1987; 66:643-646
© 1987 International Anesthesia Research Society
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Cadaver Anatomic Analysis of the Best Site for Chemical Lumbar Sympathectomy

Shinichiro Umeda, MD, Toshiyuki Arai, MD, Yoshio Hatano, MD, PhD, Kenjiro Mori, MD, PhD, and Kazumasa Hoshino, MD, PhD

Received from the Departments of Anesthesiology and Anatomy, Faculty of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan. Address correspondence to Dr. Umeda, Department of Anesthesiology, Kyoto University Hospital, Sakyo-ku, Kyoto 606, Japan.

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.

Key Words: ANATOMY—lumbar sympathetic ganglion, lumbar artery. • ANESTHETIC TECHNIQUES—lumbar sympathetic block.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1987 by the International Anesthesia Research Society.