{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T21:28:10Z","timestamp":1780694890900,"version":"3.54.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,7,5]],"date-time":"2019-07-05T00:00:00Z","timestamp":1562284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100007052","name":"MSKCC","doi-asserted-by":"publisher","award":["P 30"],"award-info":[{"award-number":["P 30"]}],"id":[{"id":"10.13039\/100007052","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The sympathetic nervous system has a recognized role in transmission of pain, and the lumbar sympathetic blockade is intended to provide analgesia. We share our experiences of lumbar sympathetic blockade in the treatment of cancer-related pain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a retrospective analysis of patients with cancer-related pain in the back, abdomen, pelvis, or legs treated at Memorial Sloan Kettering Cancer Center between 2000 and 2018 undergoing lumbar sympathetic blockade at L2 or L3. Blocks were accomplished by injection of local anesthetic or local anesthetic with steroid under fluoroscopy. We measured numerical rating scale scores, percent relief, and relief time. The primary end point was defined as \u201ceffective\u201d or \u201cineffective\u201d pain relief. Effective pain relief was defined as \u226530% relief for at least one day.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 124 data points of lumbar sympathetic blockade at L2 or L3, of which 57 were with complete data and used for analysis. Peri-injection, 42 data points had active disease whereas 15 were in remission. Lumbar sympathetic blockade was 67% effective in the back pain cohort, 82% effective in the abdominopelvic pain cohort, and 75% effective in the leg pain cohort. Seventeen data points went on to neurolysis, two to neuromodulation, and eight to intrathecal pump implantation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Lumbar sympathetic blockade is effective for back, abdominopelvic, and leg pain related to cancer and its treatments. Future research should be aimed at refining its role within multimodal pain management.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnz142","type":"journal-article","created":{"date-parts":[[2019,5,28]],"date-time":"2019-05-28T11:18:11Z","timestamp":1559042291000},"page":"176-184","source":"Crossref","is-referenced-by-count":16,"title":["The Use of L2 and L3 Lumbar Sympathetic Blockade for Cancer-Related Pain, an Experience and Recommendation in the Oncologic Population"],"prefix":"10.1093","volume":"21","author":[{"given":"Matthew A","family":"Spiegel","sequence":"first","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Hingula","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant H","family":"Chen","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron","family":"Legler","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay","family":"Puttanniah","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amitabh","family":"Gulati","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,7,5]]},"reference":[{"key":"2021032712361019500_pnz142-B1","article-title":"Spinal afferent nerve endings in visceral organs: Recent advances","author":"Spencer","journal-title":"Am J Physiol Gastrointest Liver Physiol"},{"key":"2021032712361019500_pnz142-B2","article-title":"A visceral pain pathway in the dorsal column of the spinal cord","author":"Willis","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2021032712361019500_pnz142-B3","author":"Huang"},{"key":"2021032712361019500_pnz142-B4","author":"Zechlinski"},{"issue":"3","key":"2021032712361019500_pnz142-B5","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1097\/AAP.0000000000000591","article-title":"Review of sympathetic blocks: Anatomy, sonoanatomy, evidence, and techniques","volume":"42","author":"Baig","year":"2017","journal-title":"Reg Anesth Pain Med"},{"key":"2021032712361019500_pnz142-B6","volume-title":"Atlas of Image-Guided Spinal Procedures.","author":"Furman","year":"2013"},{"issue":"2","key":"2021032712361019500_pnz142-B7","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1111\/j.1533-2500.2008.00177.x","article-title":"Sympathetic blocks: The evidence","volume":"8","author":"Day","year":"2008","journal-title":"Pain Pract"},{"key":"2021032712361019500_pnz142-B8","author":"De Oliveira"},{"key":"2021032712361019500_pnz142-B9","first-page":"CD012592.","article-title":"Opioids for cancer pain - an overview of Cochrane reviews","volume":"7","author":"Wiffen","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"issue":"10","key":"2021032712361019500_pnz142-B10","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.etp.2016.09.001","article-title":"Comparison of histopathological effects of perineural administration of bupivacaine and bupivacaine-dexmedetomidine in rat sciatic nerve","volume":"68","author":"Memari","year":"2016","journal-title":"Exp Toxicol Pathol"},{"key":"2021032712361019500_pnz142-B11","first-page":"39","article-title":"The nerve supply to the human lumbar intervertebral discs","volume":"132(Pt 1)","author":"Bogduk","year":"1981","journal-title":"J Anat"},{"key":"2021032712361019500_pnz142-B12","volume-title":"Basic and Clinical Anatomy of the Spine, Spinal Cord and ANS","author":"Cramer","edition":"3"},{"issue":"6","key":"2021032712361019500_pnz142-B13","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1177\/000992280504400615","article-title":"Persistent abdominal pain","volume":"44","author":"Wilson","year":"2005","journal-title":"Clin Pediatr (Phila)"},{"issue":"1","key":"2021032712361019500_pnz142-B14","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1111\/j.1533-2500.2010.00388.x","article-title":"Evidence-based interventional pain medicine. 16. 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