Gondring William H, Trepman Elly, Shields Byron
Heartland Health, St. Joseph, MO 64506, USA.
Foot Ankle Surg. 2009;15(3):133-8. doi: 10.1016/j.fas.2008.10.003. Epub 2008 Dec 12.
Assessment of treatment outcomes for tarsal tunnel syndrome may be improved with a standardized pain rating scale using a descriptive anatomical foot model for pretreatment and post-treatment plantar foot pain analysis.
Prospective evaluation of 46 consecutive patients (56 feet) who had non-operative and surgical treatment for tarsal tunnel syndrome. Pain intensity was documented before and after treatment with the Wong-Baker FACES Pain Rating Scale applied to the anatomic nerve regions of the plantar aspect of the foot.
In patients who had successful non-operative treatment, overall pain intensity was significantly improved in the medial calcaneal, medial plantar, and lateral plantar nerve regions. In patients who had ongoing symptoms despite non-operative treatment, surgical treatment resulted in significant pain improvement in the medial calcaneal and medial plantar, but not lateral plantar, nerve regions. Pretreatment motor nerve conduction latency was significantly greater in patients who had surgical treatment than those who had only non-operative treatment.
Anatomic pain intensity rating models may be useful in the pretreatment and follow-up evaluation of tarsal tunnel syndrome. Predictors of failed non-operative treatment included longer motor nerve conduction latency and greater predominance of foot comorbidities.
使用标准化疼痛评分量表，并结合用于治疗前和治疗后足底疼痛分析的描述性足部解剖模型，可能会改善跗管综合征治疗效果的评估。
对46例连续的跗管综合征患者（56只脚）进行非手术和手术治疗的前瞻性评估。在治疗前后，使用Wong-Baker面部表情疼痛评分量表记录足部足底解剖神经区域的疼痛强度。
在非手术治疗成功的患者中，跟骨内侧、足底内侧和足底外侧神经区域的总体疼痛强度显著改善。在尽管接受非手术治疗仍有症状的患者中，手术治疗使跟骨内侧和足底内侧神经区域的疼痛显著改善，但足底外侧神经区域未改善。接受手术治疗的患者治疗前运动神经传导潜伏期显著长于仅接受非手术治疗的患者。
解剖学疼痛强度评级模型可能有助于跗管综合征的治疗前和随访评估。非手术治疗失败的预测因素包括运动神经传导潜伏期较长和足部合并症较多。
