Camuñas-Nieves Gabriel, Fernández-Gibello Alejandro, Moroni Simone, Galluccio Felice, Fajardo-Pérez Mario, Martínez-Pérez Francisco, Simón-Pérez Eduardo, Martínez-Nova Alfonso
Clínica Vitruvio, C/María de Guzmán 47, 28003 Madrid, Spain.
Podiatry Department, San Vicente Mártir University, Pl. Almoina 3, 46003 Valencia, Spain.
Healthcare (Basel). 2025 Jul 28;13(15):1838. doi: 10.3390/healthcare13151838.
Morton's neuroma is a painful foot condition that can be treated with continuous radiofrequency. However, its efficacy is not always optimal, with failure rates of 15-20%. It has been suggested that these failures may be due to incomplete nerve ablation, allowing for nerve regeneration and persistent pain. So, the aim of this study was to assess the histological effects of continuous radiofrequency on the nerves affected by Morton's neuroma. The effect of continuous radiofrequency was evaluated in two patients with Morton's neuroma, which required open surgery excision. In both cases, radiofrequency with a standard protocol was applied ex vivo, following the surgical excision of the neuroma. A TLG10 RF generator (90 °C, 90 s) with a monopolar needle with a 0.5 cm active tip was used. Subsequently, the samples were histologically analyzed to determine the degree of nerve ablation. Histological analysis showed homogeneous focal necrosis in both cases, with lesion depths of 2.4 mm and 3.18 mm. However, areas of intact nerve tissue were identified at the periphery of the neuroma, suggesting incomplete ablation. The findings indicate that continuous radiofrequency does not guarantee total nerve ablation, which could explain recurrence in some cases. Intraoperative neurophysiological monitoring could be key to optimizing the procedure, ensuring complete interruption of nerve conduction and improving treatment efficacy.
莫顿神经瘤是一种足部疼痛病症，可通过连续射频治疗。然而，其疗效并非总是最佳，失败率为15%至20%。有人认为，这些失败可能是由于神经消融不完全，导致神经再生和持续性疼痛。因此，本研究的目的是评估连续射频对受莫顿神经瘤影响的神经的组织学效应。在两名需要进行开放性手术切除的莫顿神经瘤患者中评估了连续射频的效果。在这两个病例中，在神经瘤手术切除后，按照标准方案在体外应用射频。使用了带有0.5厘米有效尖端的单极针的TLG10射频发生器（90°C，90秒）。随后，对样本进行组织学分析以确定神经消融程度。组织学分析显示，两个病例均出现均匀的局灶性坏死，病变深度分别为2.4毫米和3.18毫米。然而，在神经瘤周边发现了完整的神经组织区域，提示消融不完全。研究结果表明，连续射频不能保证完全消融神经，这可能解释了某些病例中的复发情况。术中神经生理监测可能是优化该手术、确保神经传导完全中断并提高治疗效果的关键。
