1. 2021;24;E1075-E1083Risk Factors Affecting the Success Rate of Radiofrequency Thermocoagulation of Lumbar Sympathetic Nerve
   Retrospective Study
   Ming Yao, MD, PhD, Qiuli He, MD, Bing Huang, MD, Jie Fu, MD, Huadong Ni, MD, Ru Chen, MD, Keyue Xie, MD, Jianjun Zhu, MD, and Ge Luo, MD.

BACKGROUND: Computed tomography (CT)-guided radiofrequency thermocoagulation of lumbar sympathetic nerve has been gradually applied to the treatment of many autonomic nerve disorders, such as plantar hyperhidrosis (PH) and diabetic peripheral neuropathy (DPN). The difference in the success rate of operation between the left and right sides is not yet studied.

OBJECTIVE: This study aimed to explore a statistically significant difference between the success rate of left and right CT-guided radiofrequency thermocoagulation of lumbar sympathetic nerve and screen the risk factors affecting the success rate of the right surgery.

STUDY DESIGN: This is a single-center retrospective cohort study.

SETTING: The study was carried out in the Pain Department of the affiliated Hospital of Jiaxing College in Jiaxing, China.

METHODS: A total of 86 patients who received CT-guided radiofrequency thermocoagulation of lumbar sympathetic nerve were included in this study approved by the Ethics Committee of the affiliated Hospital of Jiaxing University. Nonparametric and chi-square tests were used to compare the operation times, CT scan times, and success rate on the left and right sides. Binary multivariate logistic regression analysis was applied to screen the risk factors on the outcome variable.

RESULTS: The bilateral operation time, CT scan times, and success rate differed significantly between the left and right sides (P < 0.05). After univariate analysis, 6 covariates (gender, body mass index, treatment history, operation time, CT scan times, and puncture needle type) were selected. Finally, the multivariate regression model screened out 2 risk factors: the operation time and puncture needle type.

LIMITATIONS: We look forward to increasing the sample size in follow-up studies and exploring relevant conclusions in randomized controlled trials.

CONCLUSION: This study proved that in CT-guided radiofrequency thermocoagulation of the lumbar sympathetic nerve, the difficulty of operation on the right side was significantly high, and the success rate was also lower than that on the contralateral side. Multivariate logistic regression analysis showed that operation time and type of puncture needle were risk factors affecting the success rate of the operation. These findings laid a foundation for the accomplishment of technical improvement and innovation in the future. A preliminary exploration was carried out to reduce the risk and complications and to improve the success rate of the operation.

KEY WORDS: Sympathetic nerve, thermocoagulation, logistic regression, risk factor