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

Spinal cord infarction occurring during thoraco-lumbar sympathectomy
J Neurol Neurosurg Psychiatry 1963;26:418-421 doi:10.1136/jnnp.26.5.418

Wednesday, August 1, 2012

Sympathetic nerves protect against blood-brain barrier disruption

http://www.ncbi.nlm.nih.gov/pubmed/7064183

Nerve regeneration commonly occurs following both surgical of chemical sympathectomy

Sympathectomy is a destructive procedure that interrupts the sympathetic nervous system. Chemical sympathectomies use alcohol or phenol injections to destroy sympathetic nervous tissue (the so‐called "sympathetic chain" of nerve ganglia). Surgical ablation can be performed by open removal or electrocoagulation (destruction of tissue with high‐frequency electrical current) of the sympathetic chain, or minimally invasive procedures using thermal or laser interruption. 

Nerve regeneration commonly occurs following both surgical of chemical ablation, but may take longer with surgical ablation.

This systematic review found only one small study (20 participants) of good methodological quality, which reported no significant difference between surgical and chemical sympathectomy for relieving neuropathic pain. Potentially serious complications of sympathectomy are well documented in the literature, and one (neuralgia) occurred in this study. 

The practice of sympathectomy for treating neuropathic pain is based on very weak evidence. Furthermore, complications of the procedure may be significant.

Authors' conclusions: The practice of surgical and chemical sympathectomy for neuropathic pain and CRPS is based on very little high quality evidence. Sympathectomy should be used cautiously in clinical practice, in carefully selected patients, and probably only after failure of other treatment options.
Editorial Group: Cochrane Pain, Palliative and Supportive Care Group.
Publication status: New search for studies and content updated (conclusions changed).
Citation: Straube S, Derry S, Moore RA, McQuay HJ. Cervico‐thoracic or lumbar sympathectomy for neuropathic pain and complex regional pain syndrome. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD002918. DOI: 10.1002/14651858.CD002918.pub2. Link to Cochrane Library. [PubMed]
Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Sunday, July 29, 2012

It is well recognized that preganglionic sympathectomy involves division of cholinergic elements and sensory fibers

It is well recognized that preganglionic sympathectomy involves division of cholinergic elements and sensory fibers. 
Theodore Cooper, Department of Surgery, St Louis University School of Medicine 
Pharmacological Reviews, 1966 Vol. 18, No. 1. Part I