ArticleInterventional pain medicine2026
Thoracic sympathetic block with botulinum toxin A for complex regional pain syndrome: a retrospective case series.
Article in Interventional pain medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors.
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Abstract
Background: Sympathetic interventions are frequently used in complex regional pain syndrome (CRPS). However, the evidence is inconclusive, and the response may depend on phenotype, anatomical target, and treatment durability. For upper-extremity CRPS, clinical data on thoracic sympathetic block (TSB) with botulinum toxin type A (BoNT-A) are lacking. Objective: To describe patient characteristics, procedural details, and clinical and thermographic outcomes after computed tomography (CT)-guided TSB with BoNT-A in upper-extremity CRPS. Methods: We performed a retrospective single-center case series of consecutive adults with upper-extremity CRPS who underwent CT-guided TSB with BoNT-A between January 2023 and March 2026. For each procedure, medical records were reviewed to descriptively assess pain change, duration of effect, repeat procedures, thermographic change, and adverse events. Results: Six patients underwent 7 procedures. Most suffered from persistent, treatment-refractory CRPS. Responses varied: 3 patients experienced a clinically meaningful analgesic benefit, 1 had thermographic improvement without clear analgesic benefit, and 2 had no meaningful response. No serious procedure-related complications were observed. Conclusion: CT-guided TSB with BoNT-A was feasible in this small retrospective series of refractory upper-extremity CRPS. Responses were heterogeneous, and thermographic improvement was not always accompanied by pain relief. The findings may prompt hypotheses regarding phenotype-based patient selection and the role of thermography.
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