Comparison of the Efficacy of the Ultrasound With Fluoroscopy in Guidance of Lumbar Sympathetic Block
Comparison of the Efficacy of the Ultrasound With Fluoroscopy in Guidance of Lumbar Sympathetic Block
This study compares the efficacy of the ultrasound with fluoroscope in guidance of lumbar
 sympathetic block (LSB). The goals of the study are; 1) To show that US-guided LSB results in
 shorter performance time compared to fluoroscope-guided LSB, 2) To evaluate the efficacy and
 safety of US-guided LSB, and 3) To verify that US-guided LSB has similar success rates to
 fluoroscope-guided LSB. 50 patients who are supposed to undergo LSB due to sympathetically
 maintained pain, satisfy criteria of inclusion and exclusion, and voluntarily sign the
 informed consent will be enrolled.
Inclusion Criteria:

 -  Patients who have sympathetically-mediated pain and are supposed to undergo LSB
 procedure (e.g. pain with asymmetric skin temperature of lower limb in previous
 thermography, small fiber disorder in previous quantitative sudomotor axon reflex test
 (QSART), vascular insufficiency in lower extremities, diabetic polyneuropathy,
 postherpetic neuralgia, complex regional pain syndrome, cancer-related neuropathic
 pain such as chemotherapy-induced peripheral neuropathy, other lower extremity
 neuropathies, lower extremity crush injury etc.)

 -  Numeric rating scale (NRS) ≥ 4/10

 -  Failure of previous conservative treatments, such as physiotherapy, oral medication,
 or other noninvasive treatment

 Exclusion Criteria:

 -  Previous lumbar sympathetic neurolysis

 -  Bleeding tendency

 -  Local infection

 -  Allergy to local anesthetics or contrast media

 -  Pregnancy

 -  Severe variation near procedure site-scoliosis, tumor, abdominal aneurysm, etc.

 -  BMI ≥ 30 kg/m2

 -  Cognitive dysfunction