Cozzarelli John, Sollitto Ronald J, Thapar Jyotsna, Caponigro John
Podiatry Associates of Belleville, P.C., Belleville, New Jersey 07109, USA.
Foot Ankle Spec. 2010 Dec;3(6):338-46. doi: 10.1177/1938640010379048. Epub 2010 Sep 3.
The authors discuss their rationale for the use of radiofrequency nerve ablation (RFNA) in the treatment of chronic neurogenic heel pain. Patients treated for plantar fasciitis who fail to improve after conservative and/ or surgical treatment should be reevaluated for a coexistent nerve entrapment. The results of a retrospective study of 82 patients who have undergone RFNA are presented. The patients were followed at 5, 10, and 12 years after the procedure. An evaluation of medical records was performed as a means of inclusion in this study. A standardized telephone interview was then done, and subjectively scored responses of the patients were recorded and analyzed. Of the patients, 89% reported no recurrence of pain after 5, 10, and 12 years postoperatively. The procedure is relatively easy to perform and involves inserting a 22-gauge cannula with an electrode into the areas of pain. This is done under general anesthesia. It takes approximately 15 to 20 minutes per heel to perform, depending on how many sites of tenderness have been identified. The patient is discharged with a minimal bandage and returns to shoe gear immediately following the procedure. The success rate with RFNA appears to be quite high with fewer associated risks and less post-operative morbidity.
作者讨论了使用射频神经消融术（RFNA）治疗慢性神经性足跟痛的基本原理。接受足底筋膜炎治疗但在保守治疗和/或手术治疗后未见改善的患者，应重新评估是否存在并存的神经卡压。本文介绍了一项对82例行RFNA患者的回顾性研究结果。术后对患者进行了5年、10年和12年的随访。通过查阅病历作为纳入本研究的一种方式。随后进行了标准化电话访谈，并记录和分析了患者的主观评分回答。在这些患者中，89%报告术后5年、10年和12年无疼痛复发。该手术相对容易实施，包括将带有电极的22号套管插入疼痛区域。这在全身麻醉下进行。每只足跟手术大约需要15到20分钟，具体取决于已确定的压痛部位数量。患者术后用最小的绷带包扎出院，并在术后立即恢复穿鞋。RFNA的成功率似乎相当高，相关风险较少，术后发病率较低。
