Chon Jin Young, Hahn Yun Jin, Sung Choon Ho, Jung Sung Hoon, Moon Ho Sik
Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeoungdeungpo-gu, Seoul, 150-713, Korea.
J Anesth. 2014 Dec;28(6):924-7. doi: 10.1007/s00540-014-1831-9. Epub 2014 Apr 12.
Tarsal tunnel syndrome (TTS) is a compression neuropathy that results from entrapment of the posterior tibial nerve or its branches. TTS may be treated either by conservative measures, including physical therapy, medications, and steroid injections, or by surgical decompression. Despite a variety of treatments, a few cases of TTS will relapse, and many cases of recurrent TTS will require re-operation. Pulsed radiofrequency (PRF) is known to have a number of advantages for pain management, particularly as this technique does not cause neural compromise such as motor weakness. Here, we report a new application of ultrasound-guided PRF in two cases of intractable TTS. Both patients had a long duration of severe foot pain and had been treated with various therapeutic modalities without lasting relief. We applied ultrasound-guided PRF to the affected posterior tibial nerve in each patient, and both had significantly reduced pain intensity scores and analgesic requirements without any complications. Ultrasound-guided PRF for intractable TTS relieved severe foot pain. It may supersede surgery as a reliable treatment for intractable TTS.
跗管综合征（TTS）是一种由胫后神经或其分支受压引起的压迫性神经病变。TTS可通过保守治疗措施进行治疗，包括物理治疗、药物治疗和类固醇注射，也可通过手术减压治疗。尽管有多种治疗方法，但仍有少数TTS病例会复发，许多复发性TTS病例需要再次手术。已知脉冲射频（PRF）在疼痛管理方面有许多优点，特别是因为该技术不会导致诸如运动无力等神经损伤。在此，我们报告超声引导下PRF在两例顽固性TTS中的新应用。两名患者均有长期严重的足部疼痛，并且已经接受了各种治疗方式，但均未获得持久缓解。我们对每位患者受影响的胫后神经应用了超声引导下的PRF，两名患者的疼痛强度评分和镇痛需求均显著降低，且无任何并发症。超声引导下的PRF治疗顽固性TTS可缓解严重的足部疼痛。它可能会取代手术，成为治疗顽固性TTS的可靠方法。
