Cryoablation of the Lumbar Sympathetic Chain for Complex Regional Pain Syndrome and Plantar Hyperhidrosis

Guideline-Supported Approaches for CRPS

The National Comprehensive Cancer Network recommends neurostimulation procedures as useful for Complex Regional Pain Syndrome (CRPS) patients, with a strength of evidence based on expert consensus and limited clinical trials 1, 2
Interventional therapies, such as neurostimulation, should only be considered when patients cannot achieve adequate analgesia or experience intolerable side effects from conservative management, as suggested by the National Comprehensive Cancer Network 1, 2
Contraindications to any sympathetic intervention include unwilling patients, active infections, coagulopathy, very short life expectancies, or lack of technical expertise, as outlined by the National Comprehensive Cancer Network 1, 2

Before any sympathetic intervention, a bleeding risk assessment should be performed, and anticoagulants, antiplatelet agents, or antiangiogenesis agents should be stopped for an appropriate duration before and after the procedure, as recommended by the National Comprehensive Cancer Network 1, 2
Infection screening is essential, and active infection is an absolute contraindication for sympathetic interventions, according to the National Comprehensive Cancer Network 1, 2
Coagulation status must be corrected, and technical expertise is required for sympathetic interventions, as emphasized by the National Comprehensive Cancer Network 1, 2
Patient willingness and informed consent regarding risks, benefits, and alternatives are crucial before proceeding with sympathetic interventions, as stated by the National Comprehensive Cancer Network 1, 2