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Ultrasound-Guided Percutaneous Radiofrequency for the Treatment of Morton's Neuroma
Salvatore Masala1, Alessandro Cuzzolino2, Marco Morini1
1Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.
Purpose:
Morton's neuroma (MN) is a leading cause of disability. The purpose of this study was to investigate the effectiveness of radiofrequency (RF) in patients with chronic pain refractory to conservative therapies.
Methods:
Between September 2012 and December 2016, RF was performed on 52 patients. A sterile RF needle probe (22G, 5-cm needle with 10-mm electrode active tip) was inserted between the toes into the intermetatarsal space at the center of the lesion. Potential complications of the intervention and post-procedure care were examined. All patients provided written, informed consent. All percutaneous procedures were performed with the NeuroTherm® NT1100 (Neurotherm Inc., M.) device and using ultrasound guidance (Philips IU22). Continuous RF was performed with one cycle of 90 s and with the probe tip maintaining a temperature of 85 °C (impedance 95-210 mΩ).
Results:
Mean VAS score before the procedures was 9.0 ± 0.6. A reduction of pain intensity was achieved after 1 week by RF (mean VAS scores 3.7 ± 0.9; p < 0.05), with a stabilization of the painful symptomatology in the following months and after 1 year of treatments (mean VAS scores 2.0 ± 0.4 after 12 months, p < 0.05). The FHSQ scores showed improved quality of life (QOL) in all patients at 6 months (p < 0.05) and 1 year (p < 0.05) of RF. No patients developed complications.
Conclusions:
RF is a safe, efficient, and minimally invasive technique for the treatment of symptomatic MN.
