Stellate Ganglion Block (Cervicothoracic Sympathetic Ganglion Block)

Stellate ganglion blocks can be performed to treat sympathetically maintained pain (reflex sympathetic dystrophy, causalgia, complex regional pain syndromes). The stellate ganglion is the fusion of the inferior cervical and first thoracic sympathetic ganglia. Almost all the sympathetic innervation of the head, neck, and upper extremity travels via pathways through the stellate ganglion. The stellate ganglion is approximately 0.5 to 2.5 cm in size. Despite its name, the stellate ganglion is fusiform, triangular, or globular in shape on magnetic resonance scans. The stellate ganglion can have a star-shaped appearance if the fusion of the inferior cervical and first thoracic ganglion is complete. Stellate ganglion block is used to diagnose and treat chronic pain syndromes of the upper extremity and head and neck.

At the level of the first thoracic vertebral level, the stellate ganglion lies lateral and posterior to the lateral edge of the longus colli muscle. As the cervical sympathetic chain travels cephalad, it comes to lie anterior to the longus colli muscle. This muscle lies over the anterior surface of the cervical transverse processes.