From the Interventional Radiology Unit, Imaging Department (B.M., G.A., J.L.S., O.V., M.D.P., A.H.), From the Orthopedic Surgery Unit (S.R), and From the Anesthesiology Department (TG), American Hospital of Paris, 55 Boulevard du Chateau, 92200, Neuilly-sur-Seine, France.
Cardiovasc Intervent Radiol. 2024 Jun;47(6):795-800. doi: 10.1007/s00270-024-03669-1. Epub 2024 Mar 4.
To assess the technical success, safety and early efficacy of Morton neuroma (MN) cryoneurolysis.
Retrospective review of 54 consecutive patients with MN treated with cryoneurolysis after failure of conservative treatment, from September 2022 to June 2023. Outcomes measurements included technical success (defined a successful ultrasound-guided placement of the cryoprobe), procedural safety according to Cirse classification and change in 6 months post-procedure by pain numeric rating scale (pNRS).
A total of 59 MN were treated during 55 procedures. Mean procedure duration was 47 min, all patients were discharged 2 h after the intervention. Technical success was 98.1%. No Cirse grade 3, 4 or 5 complication was reported. Three grade 2 complication occurred, including two chilblain-type lesions and one bone insufficiency fracture. At 6 months post-procedure, pNRS score was significantly decreased (2.7 ± 2.2 vs 7.1 ± 1.1) (p < 0.0001), with a mean score decrease of 4.1points. Thirty-two patients (60.4%) reported a complete pain relief, 15 (28.3%) a partial pain relief and 6 (11.3%) no pain relief, or increased pain.
Cryoneurolysis seems to be safe for the treatment of Morton neuroma. Six-month pain relief is promising and needs to be confirmed at long term.
评估莫顿神经瘤（MN）冷冻神经松解术的技术成功率、安全性和早期疗效。
回顾性分析了 2022 年 9 月至 2023 年 6 月间 54 例因保守治疗失败而接受冷冻神经松解术治疗的 MN 连续患者。主要结局指标包括技术成功率（定义为超声引导下冷冻探针成功放置）、根据 Cirse 分类的手术安全性以及术后 6 个月疼痛数字评分量表（pNRS）的变化。
共治疗了 59 个 MN，共进行了 55 次手术。平均手术时间为 47 分钟，所有患者均在干预后 2 小时出院。技术成功率为 98.1%。无 Cirse 3 级、4 级或 5 级并发症。有 3 例 2 级并发症，包括 2 例冻疮样病变和 1 例骨不愈合骨折。术后 6 个月，pNRS 评分显著降低（2.7±2.2 比 7.1±1.1）（p<0.0001），平均评分降低 4.1 分。32 例（60.4%）患者报告完全缓解疼痛，15 例（28.3%）患者报告部分缓解疼痛，6 例（11.3%）患者报告无缓解疼痛或疼痛加重。
冷冻神经松解术治疗莫顿神经瘤似乎是安全的。6 个月的疼痛缓解是有希望的，需要长期证实。
