Cryoablation of Morton?s Neuroma

NewsBot · May 21, 2016

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Percutaneous MR-Guided Cryoablation of Morton?s Neuroma: Rationale and Technical Details After the First 20 Patients
Roberto Luigi Cazzato , Julien Garnon, Nitin Ramamurthy, Georgia Tsoumakidou, Jean Caudrelier, Marie-Aude Thenint, Pramod Rao, Guillaume Koch, Afshin Gangi
CardioVascular and Interventional Radiology; pp 1-8; First online: 17 May 2016

Objectives
The purpose of this study is to discuss technical aspects and rationales of magnetic resonance (MR)-guided cryoablation (CA) of Morton?s neuroma (MN); preliminary clinical experience is also retrospectively reviewed.
Methods
Procedures were performed under local anaesthesia on an outpatient basis. Lesion size and location, procedural (technical success, procedural time, complications) and clinical outcomes (patient satisfaction according to a four-point scale, residual pain according to a 0?10 visual analogue scale and instances of ?stump neuroma?) were assessed via chart review and cross-sectional telephone survey after the 20th case.
Results
Twenty patients (15 female, 5 male; mean age 50.3 years) were included; 24 MN (mean size 12.7 mm) were treated. Technical success was 100 %. Mean procedural time was 40.9 ? 10.4 min (range 35?60). One minor complication (superficial cellulitis) was reported (4.2 %). Follow-up (mean 19.7 months) was available for 18/24 MN. Patient satisfaction on a per-lesion basis was as follows: ?completely satisfied? in 77.7 %, ?satisfied with minor reservations? in 16.6 % and ?satisfied with major reservations? in 5.7 % of cases. Mean pain score at last follow-up post-CA was 3.0. No instances of ?stump neuroma? were reported.
Conclusions
MR-guided CA of MN is a novel therapy which appears technically feasible. Clinical advantages of the procedure are high patient satisfaction, reduced risk of ?stump neuroma? syndrome and good patient tolerance on an outpatient basis. Further, prospective studies are needed to confirm these encouraging results.
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NewsBot · Jul 31, 2023

Ultrasonography-Guided Cryoablation of Morton's Neuroma: Case Series Including Post-ablation Magnetic Resonance Imaging Appearances
Dr. Kimberly Lam , Dr. Vasileios Lampridis , Dr. Alpesh Mistry , Dr. Jehan Ghany , Dr. Yajur Narang , Dr. James Cusack , Anjani Singh , Siva Sirikonda , Dr. Coonoor Chandrasekar , Dr. Lyndon Mason
Semin Musculoskelet Radiol 2023; 27(S 01): S1-S24

Purpose or Learning Objective: Morton's neuroma (MN) is a common compressive neuropathy of the interdigital nerve. Nonsurgical management is recommended initially with many therapies described.

Cryoablation has shown promising results in patients who have failed prior conservative measures such as steroid injection and alcohol ablation; however, published studies are limited.

This study assessed the safety and efficacy of cryoablation in patients with MN, including patient satisfaction. A secondary aim was to evaluate postprocedure magnetic resonance imaging (MRI) appearances at various follow-up intervals.

Methods or Background: A retrospective analysis was completed for 24 patients with MN treated between June 2021 and September 2022. All patients had refractory MN symptoms after previous ultrasonography (US)-guided steroid and lidocaine injection within the previous year. Three patients also had refractory symptoms after prior alcohol ablation.

Cryoablation was performed as a single outpatient procedure under continuous US monitoring and local anesthesia.

Telephone follow-ups were conducted using a 0 to 10 visual analog scale (VAS) score at 6 weeks and 3 months postablation as a minimum. Fourteen patients were followed up at 12 and at 18 months postprocedure. All patients were also encouraged to submit patient-reported outcomes to the British Foot and Ankle Society online scoring database, facilitated by the surgical team.

Postablation MRI was performed to evaluate for postprocedure appearances at various intervals between 3 and 14 months.

Results or Findings: A total of 24 patients with MN were treated; mean size of the MN treated was 12.3 mm. Technical success was 100%, and all patients tolerated the procedure well.

Mean preprocedure VAS pain score was 8, reduced to VAS 1 at 6 weeks and VAS 2 at 3 months at the treated MN site.

High patient satisfaction was expressed with 20 patients (83%) very satisfied. At 12- to 18-month follow-up, 11 of 14 patients (79%) reported complete and sustained pain relief with VAS 0, returning to normal activity without regular analgesia. Four patients had various persistent symptoms and requested repeat cryoablation (17%).

Postablation MRI showed various bone and soft tissue changes in the ablation zone. Two cases of fibrosis in the intermetatarsal space and one residual neuroma were observed, although it was asymptomatic in the ablation site. No complications occurred (e.g., infection, fracture or thermal injury).

Conclusion: US-guided cryoablation is a safe and effective treatment for MN. Clinical advantages include high patient tolerance and satisfaction, a single percutaneous outpatient procedure, sustained pain relief, and reduced risk of scarring/residual neuroma with a short to no disability period compared with postsurgical recovery. Further controlled prospective studies would be beneficial.
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Cryoablation of Morton?s Neuroma

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Cryoablation of Morton?s Neuroma

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Morton´s Foot vs Rothbart´s Foot

Morton´s Foot vs Rothbarts Foot

Morton's Neuroma Pads

Targeted muscle reinnervation for Morton Neuroma

BAD MORTON'S NEUROMA

Pes Cavus & Mortons Neuroma

Plantar plate tears in Morton's Neuroma

Share This Page

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