The Effects of Lumbar Sympathectomy on Bone and Soft Tissue Haemodynamics of the Leg recorded using Near Infrared Spectroscopy: A Case Report.

Abstract

Near infrared spectroscopy (NIRS) is an established tool for the measurement of microvascular haemodynamics in different tissue types. This case report outlines the novel use of NIRS for measuring total oxygenation index (TOI) and relative oxygenated and deoxygenated haemoglobin concentration changes as markers of oxygenation and blood volume in muscle and bone tissue. In particular, NIRS is used to examine differences between the left and right leg in a participant who has experienced a permanent unilateral lumbar sympathectomy following an anterior lumbar intervertebral fusion. Anatomical sites at the lateral head of the gastrocnemius, tibial diaphysis and proximal tibia were investigated with NIRS during an arterial occlusion protocol at the distal femur. Consistent differences were observed between the sympathectomised left leg and the normal right leg. These included reduced baseline TOI, reduced deoxygenation rates during occlusion, and reduced reoxygenation rates post occlusion release in the sympathectomised leg at all anatomical sites. This case report demonstrates the potential of NIRS as a research tool for investigating the microvascular effects of lumbar sympathectomy. This may be useful for further investigation into the merit of chemical lumbar sympathectomy for the treatment of a variety of conditions, including hyperhidrosis and peripheral vascular disease.