The anatomy of the lumbar sympathetic trunks in man (with special reference to the question of regeneration after sympathectomy).

Although possible to decentralize the sympathetic outflow to the leg, below the knee, by resecting only the third lumbar sympathetic ganglion, the likelihood of restoration of normal vasoconstrictor activity warrants a more extensive resection to include at least the second and third lumbar ganglia, and preferably the second, third, and fourth lumbar ganglia. When cross-over fibers are suspected or demonstrated following unilateral sympathectomy, the denervation should include the fourth and fifth lumbar ganglia. The first lumbar ganglion should be spared at least unilaterally if interference with reproductive function is to be avoided.