Kingston Hospital NHS Trust, Kingston-upon-Thames, UK.
Foot Ankle Int. 2013 Aug;34(8):1064-7. doi: 10.1177/1071100713489555. Epub 2013 May 13.
Although many treatment modalities are available for Morton's neuroma (MN), studies looking at the long-term effectiveness of most forms of treatment are scarce. The injection of MN with alcohol has gained popularity over the past 10 years with widespread media coverage. Many surgeons have anecdotally questioned the long-term effectiveness of this treatment. We reviewed a cohort of patients at an average 5-year follow-up to assess the medium-term results of alcohol injection.
We used the modified Johnson score and visual analogue scales to assess 45 of the original cohort of patients with an average follow-up of 61 months (range, 33-73 months). Any complications from the procedure were also noted.
Our results indicated that by 5 years, 16 of 45 patients had undergone surgical treatment and a further 13 patients had return of symptoms. Only 29% (13/45) remained symptom free. The visual analog scale and modified Johnson scores showed statistically significant deterioration in patients' symptoms at 5 years following alcohol injection.
Injection with alcohol sclerosant for MN has been marketed as a definitive management option comparable to surgical excision. Our investigation illustrated that although short-term results are encouraging, alcohol injection does not offer permanent resolution of symptoms for most patients and can be associated with considerable morbidity. Our investigation provides the only long-term data for alcohol injection treatment of MN.
Level II, prospective case series.
尽管有许多治疗方法可用于治疗 Morton 神经瘤（MN），但研究大多形式的治疗方法的长期效果的研究很少。在过去的 10 年中，MN 注射酒精治疗已经广受欢迎，并得到了广泛的媒体报道。许多外科医生都曾私下质疑这种治疗的长期效果。我们在平均 5 年的随访中对一组患者进行了回顾性研究，以评估酒精注射的中期结果。
我们使用改良的 Johnson 评分和视觉模拟评分法评估了最初的 45 名患者中的 45 名患者，平均随访时间为 61 个月（范围为 33-73 个月）。还记录了任何手术并发症。
我们的结果表明，5 年内，45 名患者中有 16 名接受了手术治疗，另有 13 名患者出现了症状复发。只有 29%（13/45）的患者没有症状。视觉模拟评分法和改良的 Johnson 评分显示，在接受酒精注射治疗 5 年后，患者的症状有明显的统计学恶化。
MN 注射硬化剂酒精已被宣传为一种与手术切除相当的确定性治疗选择。我们的研究表明，尽管短期结果令人鼓舞，但酒精注射并不能为大多数患者永久缓解症状，并且可能会带来相当大的发病率。我们的研究提供了 MN 酒精注射治疗的唯一长期数据。
II 级，前瞻性病例系列。
