在电刺激引导下经皮用苯酚对莫顿神经瘤进行酒精化治疗能否替代手术切除？长期结果。

Can percutaneous alcoholization of Morton's neuroma with phenol by electrostimulation guidance be an alternative to surgical excision? Long-term results.

作者信息

Samaila Elena Manuela, Ambrosini Carlo, Negri Stefano, Maluta Tommaso, Valentini Roberto, Magnan Bruno

机构信息

Department of Orthopedics and Trauma Surgery, University of Verona, Italy.

出版信息

Foot Ankle Surg. 2020 Apr;26(3):314-319. doi: 10.1016/j.fas.2019.04.004. Epub 2019 Apr 17.

DOI:10.1016/j.fas.2019.04.004

PMID:31064701

Abstract

BACKGROUND

Percutaneous alcoholization with phenol by electrostimulation guidance for the treatment of Morton's neuroma is proposed to determine a permanent chemical neurolysis.

METHODS

115 patients for 125 Morton's neuromas were treated. Ten patients were affected by multiple neuromas. Visual Analogue Scale and AOFAS score were used for the clinical assessment.

RESULTS

The mean follow-up was 8,3 years. The pre-alcoholization VAS was 85.84 ± 12.00, while at follow-up scored 28.85 ± 31.35, showing a significant decrease improving in 113/125 cases (90.4%). Treatment was considered successful with a reduction of the VAS value superior to 50% in 89 out of 125 patients (71.2%). The mean overall AOFAS score at -up was 85.09 ± 13.41.

CONCLUSIONS

Needle-electrode guided percutaneous alcoholization is an outpatient, minimally invasive procedure with low rate of complications. Better results of those obtained with traditional conservative treatments and comparable with those reported with other alcohols injections or surgical nerve excision were observed.

LEVEL OF EVIDENCE

Level IV, retrospective case series.

摘要

背景

提出通过电刺激引导经皮注射苯酚酒精来治疗 Morton 神经瘤，以确定永久性化学神经溶解。

方法

对 115 例患者的 125 个 Morton 神经瘤进行了治疗。10 例患者患有多个神经瘤。采用视觉模拟评分法和美国足踝外科协会（AOFAS）评分进行临床评估。

结果

平均随访时间为 8.3 年。注射酒精前视觉模拟评分（VAS）为 85.84±12.00，随访时为 28.85±31.35，113/125 例（90.4%）有显著下降改善。125 例患者中有 89 例（71.2%）VAS 值降低超过 50%，治疗被认为成功。随访时 AOFAS 总分平均为 85.09±13.41。