Rajan Lavan, Mizher Rami, Srikumar Syian, Fuller Robert, Ellis Scott J
Hospital for Special Surgery, New York (LR, RF, SJE).
Georgetown University School of Medicine, Washington, DC (RM).
Foot Ankle Spec. 2024 Oct;17(5):425-430. doi: 10.1177/19386400221116466. Epub 2022 Aug 5.
Revision neurectomy may be approached with either a dorsal or a plantar incision. Although a plantar approach is more commonly described, few studies have investigated outcomes following a dorsal revision neuroma excision. In this study, we performed a case series on a group of patients who underwent revision neuroma excision through a dorsal approach and reported complications and outcomes using validated patient-reported outcome measures (PROMs).
This retrospective case series included 10 patients who underwent a dorsal-approach revision neuroma excision and had preoperative and minimum 1-year postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) scores. Complications including neuroma recurrence and continued unresolved pain were obtained from the electronic medical record. Preoperative and postoperative PROMIS scores were compared to assess improvement in PROMs.
There were significant improvements in the PROMIS pain interference (P = .026), pain intensity (P = .008), and global physical health (P = .017) domains. One patient experienced recurrence of their neuroma 4 years after surgery.
This case series provides preliminary data indicating that revision neurectomy using a dorsal approach leads to satisfactory outcomes in pain-related PROMs. Further research with comparative study designs is necessary to determine if one approach is superior to the other.
Level IV: Retrospective.
翻修性神经切除术可通过背侧或足底切口进行。虽然足底入路更为常用，但很少有研究调查背侧翻修性神经瘤切除术后的结果。在本研究中，我们对一组通过背侧入路进行翻修性神经瘤切除的患者进行了病例系列研究，并使用经过验证的患者报告结局测量指标（PROMs）报告了并发症和结果。
本回顾性病例系列包括10例接受背侧入路翻修性神经瘤切除术的患者，他们有术前及术后至少1年的患者报告结局测量信息系统（PROMIS）评分。从电子病历中获取包括神经瘤复发和持续未缓解疼痛在内的并发症。比较术前和术后的PROMIS评分以评估PROMs的改善情况。
PROMIS疼痛干扰（P = .026）、疼痛强度（P = .008）和总体身体健康（P = .017）领域有显著改善。1例患者术后4年神经瘤复发。
本病例系列提供了初步数据，表明采用背侧入路的翻修性神经切除术在与疼痛相关的PROMs方面可取得满意结果。需要采用比较研究设计进行进一步研究，以确定一种入路是否优于另一种。
四级：回顾性研究。
