Department of Radiology, Hillel-Yaffe Medical Center, Hadera, Israel.
Institute of Pain Medicine, Rambam Health Care Campus, Haifa, Israel.
J Ultrasound Med. 2022 Dec;41(12):3119-3124. doi: 10.1002/jum.16026. Epub 2022 May 28.
Up to 70% of limb amputees develop chronic postamputation neuropathic pain (CPANP) which includes phantom pain and residual limb neuropathic pain due to neuroma formation. CPANP often requires invasive procedures aimed at neuroma ablation. Five amputees received 6 noninvasive magnetic resonance-guided high-intensity-focused ultrasound MRgHIFU treatments ExAblate®, Insightec, Tirat-Carmel, Israel). Although ablative temperature (>65°C) at the neuroma was reached in only 1 patient, pain intensity dropped from 5.7 at baseline to 4.3 and back to 5.6 at 3 and 6 month follow-up. Post-treatment bone necrosis was demonstrated in 1 patient. Although no firm conclusion about the effectiveness of MRgHIFU for CPANP could be drawn, further studies are warranted.
多达 70%的肢体截肢者会出现慢性截肢后神经病理性疼痛（CPANP），包括幻肢痛和由于神经瘤形成导致的残肢神经病理性疼痛。CPANP 通常需要进行侵入性手术以切除神经瘤。五名截肢者接受了 6 次非侵入性磁共振引导高强度聚焦超声 (MRgHIFU) 治疗（ExAblate®，Insightec，以色列提拉特-卡尔梅尔）。尽管只有 1 名患者的神经瘤达到了消融温度（>65°C），但疼痛强度从基线时的 5.7 分降至 3 个月和 6 个月随访时的 4.3 分和 5.6 分。1 名患者在治疗后出现了骨坏死。尽管无法对 MRgHIFU 治疗 CPANP 的效果得出明确结论，但仍需要进一步研究。
