超声引导下乙醇注射治疗 Morton 神经瘤
Ultrasound-guided alcohol injection for Morton's neuroma.
作者信息
Pasquali Cecilia, Vulcano Ettore, Novario Raffaele, Varotto Davide, Montoli Carlo, Volpe Antonio
机构信息
Department of Orthopaedics and Traumatology, Ospedale di Circolo, Luino, Italy.
Department of Orthopaedics and Traumatology, University of Insubria, Varese, Italy
出版信息
Foot Ankle Int. 2015 Jan;36(1):55-9. doi: 10.1177/1071100714551386. Epub 2014 Nov 3.
BACKGROUND
Ultrasonography-guided alcohol injection (USGAI) of Morton's neuroma represents an alternative to operative treatment. Nonetheless, the literature only reports few small studies evaluating the effectiveness of the treatment. The aim of the present retrospective study was to assess the effectiveness of USGAI to treat Morton's neuroma in 508 patients at 2 medical centers.
METHODS
Between January 2001 and January 2012, 508 patients with 540 Morton's neuroma had USGAI for Morton's neuroma. Only second and third web-space neuromas were included in this study.
RESULTS
A mean number of 3.0 (range, 1 to 4) injections were performed for each neuroma. Mean local inflammatory reaction was 0.7 (range, 0 to 2). There were no other local or systemic complications. The overall mean pre-USGAI VAS score was 8.7 (range, 6 to 10), while the post-USGAI VAS score at 1 year was 3.6 (range, 0 to 9). The delta VAS between the pre- and post-USGAI was statistically significant (P < .0001). At 1-year follow-up 74.5% of patients were satisfied with the procedure.
CONCLUSION
USGAI produced encouraging results in over 500 patients affected by Morton's neuroma. The procedure proved to be safe in all patients.
LEVEL OF EVIDENCE
Level IV, retrospective case series.
背景
超声引导下注射酒精（USGAI）治疗 Morton 神经瘤是手术治疗的一种替代方法。尽管如此，文献中仅报道了少数评估该治疗效果的小型研究。本回顾性研究的目的是评估 USGAI 在两家医疗中心对 508 例患者治疗 Morton 神经瘤的有效性。
方法
2001 年 1 月至 2012 年 1 月期间，508 例患有 540 个 Morton 神经瘤的患者接受了 USGAI 治疗 Morton 神经瘤。本研究仅纳入第二和第三趾蹼间隙神经瘤。
结果
每个神经瘤平均注射次数为 3.0 次（范围 1 至 4 次）。局部平均炎症反应为 0.7（范围 0 至 2）。未出现其他局部或全身并发症。USGAI 前平均视觉模拟评分（VAS）为 8.7（范围 6 至 10），而 1 年后 USGAI 后的 VAS 评分为 3.6（范围 0 至 9）。USGAI 前后的 VAS 差值具有统计学意义（P <.0001）。在 1 年随访时，74.5%的患者对该治疗满意。
结论
USGAI 对 500 多名受 Morton 神经瘤影响的患者产生了令人鼓舞的结果。该治疗方法在所有患者中均被证明是安全的。
证据级别
IV 级，回顾性病例系列。
Zotero 插件