Chemical lumbar sympathetic block in the treatment of plantar hyperhidrosis: a study of 69 patients

Abstract

BACKGROUND: Plantar hyperhidrosis is a distressing problem that can affect a patient's quality of life. Although various conservative modalities have been suggested, severe plantar hyperhidrosis is often not sufficiently treated.

OBJECTIVE: The aim of this study was to evaluate the safety and the effectiveness of a chemical lumbar sympathetic block (CLSB) with alcohol in patients with severe plantar hyperhidrosis.

METHOD: Sixty-nine patients were treated by a neurolytic lumbar block. A single-needle or two-needle technique was used with patients in the prone position.

RESULTS: Of 138 procedures, the number of successful blocks was 68 (49.3%) for L3 to L4 and 28 (20.3%) for L4 to L5. The degree of anhydrosis was excellent in 6 patients (8.7%), good in 32 patients (46.4%), fair in 32 patients (34.8%), and poor in 7 patients (10.1%). Of 69 patients, 56 (81.1%) were partially or fully satisfied. Noted complications included temporary sexual dysfunction in 1 patient, compensatory hyperhidrosis in 1 patient, and transient genitofemoral neuritis in 3 patients. Although 62 patients (89.9%) recurred at 6 to 18 months, 3 patients (4.3%) remained stable until 18 to 24 months.

CONCLUSION: The careful use of CLSB on an outpatient basis can be a safe, minimally invasive, and effective treatment for severe plantar hyperhidrosis.