Department of Radiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, B15 2WB, UK.
Department of Anaesthetics and Pain Management, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, B15 2WB, UK.
Clin Radiol. 2019 Oct;74(10):815.e9-815.e13. doi: 10.1016/j.crad.2019.07.002. Epub 2019 Aug 10.
To assess the efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) for treatment of symptomatic Morton's neuroma.
Patients with symptomatic Morton's neuroma of the foot were referred for treatment with RFA, prior to consideration for surgery. All neuromas were proven by ultrasound imaging and had a trial of conservative management including orthotic support and/or steroid injections. Ultrasound-guided RFA was performed as an outpatient procedure under local anaesthetic. Patients were followed up at 8 weeks and 8 months. Outcomes were assessed with a visual analogue scale (VAS) score, Manchester-Oxford Foot and Ankle Questionnaire, overall patient satisfaction, and complications.
Twenty-two neuromas were treated with RFA under ultrasound guidance. The VAS score at 8 weeks was significantly lower than the VAS score pre-procedure (p<0.001, Wilcoxon signed ranks test) and the VAS score at 8 months was significantly lower than the VAS score at 8 weeks (p=0.008, Wilcoxon signed ranks test). At 8 months, 89% of treated patients were satisfied with the procedure outcome. No significant adverse effects were recorded.
Ultrasound-guided RFA is safe, with excellent initial results in treatment of symptomatic Morton's neuroma. Further studies on long-term outcomes and comparison to other management options will be required to establish its role in management of symptomatic Morton's neuroma.
评估超声引导下射频消融（RFA）治疗症状性 Morton 神经瘤的疗效和安全性。
有足部症状性 Morton 神经瘤的患者在考虑手术前被转诊接受 RFA 治疗。所有神经瘤均通过超声成像证实，并经过保守治疗（包括矫形支持和/或类固醇注射）的尝试。超声引导下的 RFA 作为门诊程序在局部麻醉下进行。患者在 8 周和 8 个月时进行随访。通过视觉模拟评分（VAS）评分、曼彻斯特-牛津足部和踝关节问卷、总体患者满意度和并发症来评估结果。
22 个神经瘤在超声引导下接受 RFA 治疗。8 周时的 VAS 评分明显低于术前（p<0.001，Wilcoxon 符号秩检验），8 个月时的 VAS 评分明显低于 8 周时（p=0.008，Wilcoxon 符号秩检验）。8 个月时，89%的治疗患者对手术结果满意。未记录到明显的不良反应。
超声引导下 RFA 是安全的，在治疗症状性 Morton 神经瘤方面具有出色的初始效果。需要进一步研究长期结果并与其他治疗选择进行比较，以确定其在治疗症状性 Morton 神经瘤中的作用。
