Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany.
Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany.
Cardiovasc Intervent Radiol. 2022 Feb;45(2):223-227. doi: 10.1007/s00270-021-02998-9. Epub 2021 Nov 24.
To assess the feasibility and outcome of ultrasound-guided cryoablation in patients with a sensitized stump neuroma after limb amputation.
Seven patients (3 females, 4 males; mean age 42 years) were included in this retrospective study. Ultrasound-guided cryoablation of a previously identified painful stump neuroma was performed. Pain was assessed on the visual analogue scale (VAS) and compared before and after cryoablation (Wilcoxon Test). The degree of pain alleviation was correlated with patient age, duration of pain before ablation and time interval between amputation and ablation (Spearman correlation). A p-value less than 0.05 was deemed statistically significant.
Nine cryoablations were performed for 8 neuromas. Technical success was 100%, there were no major complications. Mean follow-up was 27 months. There was a statistically significant decrease of pain from mean 8.3 / 10 (baseline) to 4 /10 (on day one), 2.1 / 10 (at one week) and 3 / 10 (at last follow-up) (p < 0.05). Patient satisfaction with cryoablation treatment was very high (median score 70 / 100).
In our small population observational study, ultrasound-guided cryoablation of a sensitized stump neuroma was effective and safe for pain alleviation with very good long-term results.
Level 2, Observational study with dramatic effect.
评估超声引导下冷冻消融治疗截肢后致敏残端神经瘤的可行性和疗效。
本回顾性研究纳入了 7 名患者（3 名女性，4 名男性；平均年龄 42 岁）。对先前确定的疼痛性残端神经瘤进行超声引导下冷冻消融。使用视觉模拟评分法（VAS）评估疼痛，并与冷冻消融前后进行比较（Wilcoxon 检验）。疼痛缓解程度与患者年龄、消融前疼痛持续时间和截肢与消融之间的时间间隔相关（Spearman 相关分析）。p 值小于 0.05 被认为具有统计学意义。
共对 8 个神经瘤的 9 个部位进行了冷冻消融。技术成功率为 100%，无重大并发症。平均随访时间为 27 个月。疼痛从平均 8.3/10（基线）显著下降至 4/10（术后第 1 天）、2.1/10（术后第 1 周）和 3/10（末次随访）（p<0.05）。患者对冷冻消融治疗的满意度非常高（中位数评分为 70/100）。
在我们的小样本观察性研究中，超声引导下冷冻消融治疗致敏残端神经瘤在缓解疼痛方面是有效且安全的，且长期疗效良好。
2 级，具有显著疗效的观察性研究。
