Purpose

To assess the technical success, safety and early efficacy of Morton neuroma (MN) cryoneurolysis.

Materials and Methods

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).

Results

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.

Conclusion

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.

Graphical Abstract

中文翻译：

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超声引导下经皮莫顿神经瘤冷冻神经松解术的安全性和有效性

目的

评估莫顿神经瘤 (MN) 冷冻神经松解术的技术成功性、安全性和早期疗效。

材料和方法

对 2022 年 9 月至 2023 年 6 月期间保守治疗失败后连续接受冷冻神经松解术的 54 名 MN 患者进行回顾性分析。结果测量包括技术成功（定义成功的超声引导冷冻探头放置）、根据 Cirse 分类和变更的手术安全性术后 6 个月内通过疼痛数字评定量表 (pNRS) 进行评估。

结果

在 55 次手术中，共有 59 名 MN 接受了治疗。平均手术持续时间为 47 分钟，所有患者在干预后 2 小时出院。技术成功率为98.1%。未报告 Cirse 3 级、4 级或 5 级并发症。发生 3 例 2 级并发症，其中 2 例为冻疮型病变，1 例为骨供血不足性骨折。术后 6 个月，pNRS 评分显着下降（2.7 ± 2.2 vs 7.1 ± 1.1）（p  < 0.0001），平均评分下降 4.1 分。32 名患者 (60.4%) 报告疼痛完全缓解，15 名患者 (28.3%) 部分疼痛缓解，6 名患者 (11.3%) 疼痛未缓解或疼痛加剧。

结论

冷冻神经松解术似乎对于莫顿神经瘤的治疗是安全的。六个月的疼痛缓解效果是有希望的，但需要长期证实。

图形概要