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超声引导下创伤性髋关节离断神经瘤的冷冻消融术

Ultrasound-Guided Cryoablation of a Traumatic Hip Disarticulation Neuroma.

作者信息

Ramsook Ryan R, Spinner David

机构信息

Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

出版信息

Pain Pract. 2017 Sep;17(7):941-944. doi: 10.1111/papr.12534. Epub 2016 Dec 30.

Abstract

OBJECTIVE

Traumatic amputation at the pelvic level is a rare procedure with few studies addressing long-term complications. Painful neuroma formation may form at the site of nerve transection and cause significant impairments in daily living. Ultrasound-guided cryoablation therapy has grown in popularity and should be considered in patients with painful neuromas. This is a case report of complete pain relief in a patient with rare traumatic hip disarticulation with neuroma formation, treated with ultrasound-guided cryoablation. The patient gave consent for publication.

DESIGN

Single case report.

SETTING

Mount Sinai Medical Center.

PATIENT

A 57-year-old man with traumatic hip disarticulation over 30 years ago with a 10-year history of severe residual limb pain from neuroma formation.

INTERVENTIONS

Ultrasound-guided cryoablative injection therapy.

OUTCOME MEASURES

Pain reduction.

RESULTS

Ultrasound-guided cryoablation of a traumatic hip disarticulation neuroma resulting in complete pain relief and improved functionality and independence.

CONCLUSIONS

This case illustrates a rare incidence of painful neuroma formation in a patient with traumatic hip disarticulation. Cryoablation with ultrasound guidance resulted in resolution of all pain. We report, to the best of our knowledge, the first occasion of an ultrasound-guided cryoablation resulting in complete pain relief in a traumatic hip disarticulation neuroma.

摘要

目的

骨盆水平的创伤性截肢是一种罕见的手术,针对其长期并发症的研究较少。神经切断部位可能形成疼痛性神经瘤,对日常生活造成严重影响。超声引导下的冷冻消融治疗越来越受欢迎,对于患有疼痛性神经瘤的患者应予以考虑。本文报告了一例采用超声引导下冷冻消融治疗的罕见创伤性髋关节离断伴神经瘤形成患者实现完全疼痛缓解的病例。患者同意发表此病例。

设计

单病例报告。

地点

西奈山医疗中心。

患者

一名57岁男性,30多年前发生创伤性髋关节离断,因神经瘤形成有10年严重残肢疼痛病史。

干预措施

超声引导下冷冻消融注射治疗。

观察指标

疼痛减轻情况。

结果

超声引导下对创伤性髋关节离断神经瘤进行冷冻消融,实现了完全疼痛缓解,并改善了功能和独立性。

结论

本病例说明了创伤性髋关节离断患者中疼痛性神经瘤形成的罕见情况。超声引导下的冷冻消融使所有疼痛症状得以消除。据我们所知,我们首次报告了超声引导下冷冻消融使创伤性髋关节离断神经瘤实现完全疼痛缓解的情况。

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