Mobbs R J, Vonau M, Blum P
Department of Neurosurgery, Institute of Neurological Sciences, The Prince of Wales Hospital, Sydney, Australia.
J Clin Neurosci. 2003 May;10(3):338-9. doi: 10.1016/s0967-5868(03)00010-9.
Painful neuromas form on cutaneous nerves as a result of trauma, pressure, stretch or entrapment. Since the earliest descriptions of neuromas, proposed treatments have been met with poor results and controversy. The myriad of treatments described include: simple division of an affected nerve, implantation into muscle or bone, silicon sleeves and caps, repeated injection of steroids, end-to-side neurorrhaphy, medication and vein caps to name a few. Due to encouraging recent reports of treatment of painful neuromas by vein implantation, the authors describe a simple technique to achieve this surgical goal. As veins are readily accessible due to their proximity in the neurovascular bundle, they serve as a ready source for grafting. The advantages include minimisation of trauma to bone and muscle as compared with previous treatment techniques and the relative ease of the method.
创伤、压力、拉伸或卡压会导致皮神经上形成疼痛性神经瘤。自最早对神经瘤进行描述以来,所提出的治疗方法效果不佳且存在争议。所描述的众多治疗方法包括:简单地切断受影响的神经、植入肌肉或骨骼、使用硅套管和帽状物、反复注射类固醇、端侧神经缝合术、药物治疗以及静脉帽等等。鉴于近期关于静脉植入治疗疼痛性神经瘤的报道令人鼓舞,作者描述了一种实现这一手术目标的简单技术。由于静脉在神经血管束中位置临近,易于获取,它们可作为现成的移植来源。与先前的治疗技术相比,其优点包括对骨骼和肌肉的创伤最小化以及该方法相对简便。