Joshi Dharmdev H, Thawait Gaurav K, Del Grande Filippo, Fritz Jan
Section of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N. Caroline Street, JHOC 3140A, Baltimore, MD, 21287, USA.
Ospedale Regionale di Lugano, Servizio di Radiologia, Lugano, Ticino, Switzerland.
Skeletal Radiol. 2017 Jul;46(7):983-987. doi: 10.1007/s00256-017-2617-6. Epub 2017 Mar 15.
Neuropathy of the posterior femoral cutaneous nerve may manifest as pain and paresthesia in the skin over the inferior buttocks, posterior thigh, and popliteal region. Current treatment options include physical and oral pain therapy, perineural injections, and surgical neurectomy. Perineural steroid injections may provide short-term pain relief; however, to our knowledge, there is currently no minimally invasive denervation procedure for sustained pain relief that could serve as an alternative to surgical neurectomy. Percutaneous cryoablation of nerves is a minimally invasive technique that induces a sustained nerve conduction block through temporary freezing of the neural layers. It can result in long-lasting pain relief, but has not been described for the treatment of neuropathy-mediated PFCN pain. We report a technique of MR-guided cryoablation of the posterior femoral cutaneous nerve resulting in successful treatment of PFCN-mediated sitting pain. Cryoablation of the posterior femoral cutaneous nerve seems a promising, minimally invasive treatment option that deserves further investigation.
股后皮神经病变可能表现为下臀部、大腿后侧及腘窝区域皮肤的疼痛和感觉异常。目前的治疗选择包括物理治疗和口服止痛治疗、神经周围注射以及手术神经切除术。神经周围类固醇注射可能提供短期疼痛缓解；然而，据我们所知，目前尚无用于持续缓解疼痛的微创去神经支配手术可作为手术神经切除术的替代方法。经皮神经冷冻消融是一种微创技术，通过临时冷冻神经层诱导持续的神经传导阻滞。它可导致长期疼痛缓解，但尚未见用于治疗神经病变介导的股后皮神经疼痛的报道。我们报告了一种磁共振引导下股后皮神经冷冻消融技术，成功治疗了股后皮神经介导的坐位疼痛。股后皮神经冷冻消融似乎是一种有前景的微创治疗选择，值得进一步研究。
