• Jiachun Tao, Bing Huang, Jiayi Tang, Ge Luo, Jianjun Zhu, Qiuli He, Huadong Ni, Keyue Xie, and Ming Yao.
• Department of Anesthesiology and Pain Research Center, the Affiliated Hospital of Jiaxing University, Jiaxing, China.
• Pain Physician. 2022 Mar 1; 25 (2): E357-E364.

BackgroundCold hypersensitivity in the hands and feet (CHHF) is a disease characterized by abnormal cold in the limbs with limited treatment options. Compared to traditional drug therapy, lumbar sympathectomy is a new minimally invasive surgical method for treating CHHF.ObjectivesThe present study aimed to compare the efficacy and safety of lumbar sympathetic radiofrequency thermocoagulation (RFT) and chemical lumbar sympathectomy (CLS) in treating CHHF.Study DesignA single-center, retrospective, observational study.SettingDepartment of Anesthesiology and Pain Medicine, Jiaxing, China.MethodsA total of 102 patients with CHHF who underwent lumbar sympathectomy from January 2016 to April 2020 were included in this study. According to the mode of operation, the patients were divided into 2 groups: CLS (n = 56) and RFT (n = 46). All patients were treated under the guidance of computed tomography (CT). The foot temperature (T) and peripheral perfusion index (PI) were compared between the 2 groups before and after treatment. The 2 groups' visual analog scale (VAS) scores were evaluated before the operation and 1 day, 1 month, 3 months, 6 months, and 1 year after the treatment. The postoperative recurrence rate of the 2 groups was observed 1 year after treatment. The short and long-term complications during the postoperative follow-up were recorded.ResultsAll patients completed the operation successfully. No significant difference was noted in the gender, age, course of the disease, preoperative T and PI, and postoperative T and PI between the 2 groups (P > 0.05). The postoperative T and PI were significantly increased compared to preoperative in both groups (P < 0.05). No significant difference was observed in T and PI between the 2 groups (P > 0.05), and no significant difference was recorded in VAS scores between the 2 groups 1 day and 1 month after the treatment (P > 0.05). The VAS scores at 3 months, 6 months, and 1 year after the treatment were significantly lower in the RFT group compared to the CLS group (P < 0.05). During the 1-year follow-up, patients who received CLS had a higher risk of recurrence than RFT treatment (P < 0.05). The RFT group treatment of CHHF showed better long-term outcomes than the CLS group. About 12.5% of patients in the CLS group and 6.5% in the RFT group had postoperative complications, including pain at the puncture site and genitofemoral neuralgia. However, no severe complications or deaths were observed in either of the 2 groups.LimitationsThe was a single-center, retrospective, non-randomized study, which is a major limitation of this study.ConclusionsLumbar sympathetic RFT had better long-term efficacy, lower recurrence, and fewer complications than the chemical lumbar sympathectomy when treating CHHF.

14 keywords...

hide…