Lumbar Sympathetic Nerve Block

The patient was felling cold and numb in bilateral lower extremity in last 7 years. He complained that his legs and feet are always like exposed in frigid winter! Examination showed that his vessels are normal, and the pain is caused by lumbar sympathetic nerve dysfunction. The patient was given ultrasound-guided lumbar sympathetic block using intervertebral disc approach. 5ml of contrast agent was injected when the needle reached the midpoint of the anterior edge of the intervertebral disc. C-arm showed that liquids are evenly diffused to the anterior edge of bilateral vertebral body, and then 20ml (0.5% lidocaine + 10mg triamcinolone acetonide) was given. Right after five minutes, the patient felt warmth in his legs, as if winter has gone and summer has come!