Can percutaneous alcoholization of Morton's neuroma with phenol by electrostimulation guidance be an alternative to surgical excision? Long-term results.
Alcoholization
Conservative treatment
Morton’s neuroma
Phenol
Journal
Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons
ISSN: 1460-9584
Titre abrégé: Foot Ankle Surg
Pays: France
ID NLM: 9609647
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
27
12
2018
revised:
26
03
2019
accepted:
07
04
2019
pubmed:
9
5
2019
medline:
15
12
2020
entrez:
9
5
2019
Statut:
ppublish
Résumé
Percutaneous alcoholization with phenol by electrostimulation guidance for the treatment of Morton's neuroma is proposed to determine a permanent chemical neurolysis. 115 patients for 125 Morton's neuromas were treated. Ten patients were affected by multiple neuromas. Visual Analogue Scale and AOFAS score were used for the clinical assessment. The mean follow-up was 8,3 years. The pre-alcoholization VAS was 85.84 ± 12.00, while at follow-up scored 28.85 ± 31.35, showing a significant decrease improving in 113/125 cases (90.4%). Treatment was considered successful with a reduction of the VAS value superior to 50% in 89 out of 125 patients (71.2%). The mean overall AOFAS score at -up was 85.09 ± 13.41. Needle-electrode guided percutaneous alcoholization is an outpatient, minimally invasive procedure with low rate of complications. Better results of those obtained with traditional conservative treatments and comparable with those reported with other alcohols injections or surgical nerve excision were observed. Level IV, retrospective case series.
Sections du résumé
BACKGROUND
BACKGROUND
Percutaneous alcoholization with phenol by electrostimulation guidance for the treatment of Morton's neuroma is proposed to determine a permanent chemical neurolysis.
METHODS
METHODS
115 patients for 125 Morton's neuromas were treated. Ten patients were affected by multiple neuromas. Visual Analogue Scale and AOFAS score were used for the clinical assessment.
RESULTS
RESULTS
The mean follow-up was 8,3 years. The pre-alcoholization VAS was 85.84 ± 12.00, while at follow-up scored 28.85 ± 31.35, showing a significant decrease improving in 113/125 cases (90.4%). Treatment was considered successful with a reduction of the VAS value superior to 50% in 89 out of 125 patients (71.2%). The mean overall AOFAS score at -up was 85.09 ± 13.41.
CONCLUSIONS
CONCLUSIONS
Needle-electrode guided percutaneous alcoholization is an outpatient, minimally invasive procedure with low rate of complications. Better results of those obtained with traditional conservative treatments and comparable with those reported with other alcohols injections or surgical nerve excision were observed.
LEVEL OF EVIDENCE
METHODS
Level IV, retrospective case series.
Identifiants
pubmed: 31064701
pii: S1268-7731(19)30057-8
doi: 10.1016/j.fas.2019.04.004
pii:
doi:
Substances chimiques
Sclerosing Solutions
0
Phenol
339NCG44TV
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
314-319Informations de copyright
Copyright © 2019 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.