Hughes Richard J, Ali Kaline, Jones Hugh, Kendall Sue, Connell David A
Department of Radiology, Royal National Orthopaedic Hospital and Kingston Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, United Kingdom.
AJR Am J Roentgenol. 2007 Jun;188(6):1535-9. doi: 10.2214/AJR.06.1463.
Morton's neuroma is a common cause of forefoot pain. For this study, we assessed the efficacy of a series of sonographically guided alcohol injections into the lesion.
One hundred one consecutive patients with Morton's neuroma were included in this prospective series. An average of 4.1 treatments per person were administered, and follow-up images were obtained at a mean of 21.1 months after the last treatment (range, 13-34 months).
Technical success was 100%. Partial or total symptom improvement was reported by 94% of the patients, with 84% becoming totally pain-free. The median visual assessed pain score decreased from 8 before treatment to 0 after treatment (p < 0.001). Transitory increased local pain occurred in 17 cases (16.8%). There were no major complications. Thirty patients underwent sonography at 6 months after the last injection and showed a 30% decrease in the size of the neuroma.
We conclude that alcohol injection of Morton's neuroma has a high success rate and is well tolerated. The results are at least comparable to surgery, but alcohol injection is associated with less morbidity and surgical management may be reserved for nonresponders.
Morton神经瘤是前足疼痛的常见原因。在本研究中，我们评估了一系列超声引导下向病变内注射酒精的疗效。
本前瞻性研究纳入了101例连续的Morton神经瘤患者。每人平均接受4.1次治疗，并在最后一次治疗后平均21.1个月（范围13 - 34个月）获得随访图像。
技术成功率为100%。94%的患者报告症状部分或完全改善，84%的患者完全无痛。视觉评估的疼痛评分中位数从治疗前的8分降至治疗后的0分（p < 0.001）。17例（16.8%）出现短暂的局部疼痛加重。无重大并发症。30例患者在最后一次注射后6个月接受超声检查，神经瘤大小减小了30%。
我们得出结论，向Morton神经瘤内注射酒精成功率高且耐受性良好。结果至少与手术相当，但注射酒精的发病率较低，手术治疗可保留给无反应者。
